Transorbital Ultrasonographic Measurement of Optic Nerve Sheath Diameter for Intracranial Midline Shift in Patients with Head Trauma

Kazdal, Hızır; Kanat, Ayhan; Fındık, Hüseyin; Şen, Ahmet; Özdemi̇r, Bülent; Batçık, Osman Ersegun; Yavaşı, Özcan; İnecikli, Mehmet Fatih

doi:10.1016/j.wneu.2015.10.015

Cited by 40 publications

(24 citation statements)

References 33 publications

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“…With further technical and methodological development in the last decades, enabling the quantification of diameters of optic nerve and his sheaths, TOS became a promising novel diagnostic tool in neurology and intensive care medicine. The main areas of application are diseases with increased intracranial pressure such as idiopathic intracranial hypertension, intracranial hemorrhage, and neuro‐traumatological diseases . In this context, TOS provides a helpful diagnostic tool for early prognostication of hypoxic‐ischemic encephalopathy after cardiac arrest .…”

Section: Introductionmentioning

confidence: 99%

Quantification of Optic Nerve and Sheath Diameter by Transorbital Sonography: A Systematic Review and Metanalysis

Schroeder

Katsanos

Richter

et al. 2020

Journal of Neuroimaging

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BACKGROUND AND PURPOSE To date, normal values for optic nerve diameter (OND) and optic nerve sheath diameter (ONSD) for transorbital sonography (TOS) have only been reported by individual small‐scale studies, exposing a great variability in the measurement of the OND and ONSD. METHODS We performed a systematic review and metanalysis of available to date studies on TOS evaluation of adults without elevated intracranial pressure to provide an overview of the published literature, measuring methods and further specify normal values for OND and ONSD. RESULTS In total, we included 39 studies with 2,927 healthy volunteers (mean age 36.1 years, 44.4% female), so that a total of 5,854 eyes were examined. All pooled analyses were based on random effect models. Mean values for OND were provided in 13 studies. Calculated mean pooled OND value was 3.08 mm (95% confidence interval [CI], 2.9‐3.25), with low heterogeneity across studies (I2 = 12.7%). Thirty‐four studies provided mean values for ONSD measurement. The pool of mean ONSD measurements was 4.78 mm (95% CI, 4.63‐4.94), with evidence of substantial heterogeneity between estimates ONSD (I2 = 50.6%). There were no significant differences (P = .139) in the subsequent subgroup analysis for the different geographic continents. Also, no significant differences could be recorded for the effect of age (P = .824) or gender (P = .093). CONCLUSIONS TOS is a frequently described and widely used method. We provide reference values of OND and ONSD that are based on metanalytical analysis. Different measuring methods of ONSD result in higher heterogeneity. Subgroup analysis revealed no significant correlation between ONSD and age, gender, or geographic origin.

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Section: Introductionmentioning

confidence: 99%

Quantification of Optic Nerve and Sheath Diameter by Transorbital Sonography: A Systematic Review and Metanalysis

Schroeder

Katsanos

Richter

et al. 2020

Journal of Neuroimaging

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“…The optic nerve is an outward form of the diencephalon which developed during embryogenesis, wrapped by a nerve sheath derived from three layers of meninges and protruding toward the orbit. 26 As a consequence of this communication, CSF can transfer freely between the intracranial and intraorbital subarachnoid space. 26 ICP is transmitted within the optic nerve sheath to obstruct the venous drainage from the eye.…”

Section: Pathogenetic Mechanisms Of Retinal Detachmentmentioning

confidence: 93%

“…26 As a consequence of this communication, CSF can transfer freely between the intracranial and intraorbital subarachnoid space. 26 ICP is transmitted within the optic nerve sheath to obstruct the venous drainage from the eye. ICP is frequently elevated following aneurysmal SAH.…”

Section: Pathogenetic Mechanisms Of Retinal Detachmentmentioning

confidence: 93%

Describing a New Mechanism of Retinal Detachment Secondary to Ophthalmic Artery Vasospasm Following Subarachnoid Hemorrhage: An Experimental Study

Fındık

Kanat

Aydın

et al. 2019

J Neurol Surg A Cent Eur Neurosurg

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Background The pterygopalatine ganglion (PPG) and ophthalmic arteries (OpAs) have important roles in ocular autoregulation and retinal and visual functions. The relationship between PPG neuron density, OpA vasospasm, and retinal detachment in subarachnoid hemorrhage (SAH) has never been studied. Methods This study was conducted on 25 rabbits. Five animals were in the control group (GI; n = 5), five in the sham group (GII; n = 5), and 15 in the study group (GIII; n = 15). After injection of 1 cc serum saline into the cisterna magna in the sham group, and autologous blood in the SAH group, the animals were followed for 3 weeks. All animals underwent a retinal examination five times a week for 3 weeks before and after the experiment. After the experiment, the neuron density of PPGs of the facial nerves, vasospasm index (VSI) of OpAs, and total basal surface values of the detached retinal parts (DRPs) were calculated. Results In the funduscopic examination, intravitreous hemorrhage ( Terson's syndrome) was detected in four animals in the SAH group. In the control groups, neuron density was 12,000 ± 1,240/mm3, VSI = 0.345 ± 0.076, and DRP = 0 to 1.5 mm2. Mean neuron density was 9,450 ± 940/mm3, VSI = 1.645 ± 0.940, and DRP = 6.23 ± 1.61 mm2 in the sham group (p < 0.05). Neuron density was 6,890 ± 932/mm3, VSI = 2.92 ± 0.97, and DRP = 9.43 ± 2.54 mm2 in SAH group. Conclusion Mean neuron density, VSI of OpAs, and DRP values differed statistically significant between the SAH group and other groups (p < 0.005). There is an inverse relationship between PPG neurons and DRP. However, a direct relationship was observed between the mean VSI and DRP values.

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“…40 Several other approaches were reported based on the ventral transorbital route, including intraventricular procedures, 34,[47][48][49] decompression for orbital and Graves' disease, 1,3,33 and experimental and diagnostic vascular applications. 12,17,27,28,37 Thereafter, targets such as the cavernous sinus, 6,16,41 pituitary stalk, 42 and optic nerve 29,45 were considered reachable via this minimally invasive avenue for various diagnostic, experimental, and/or therapeutic purposes.…”

Section: Evolution Of the Transorbital Pathmentioning

confidence: 99%

Endoscopic transorbital superior eyelid approach: anatomical study from a neurosurgical perspective

Somma

Andaluz²,

Cavallo

et al. 2018

Journal of Neurosurgery

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OBJECTIVE Recent studies have proposed the superior eyelid endoscopic transorbital approach as a new minimally invasive route to access orbital lesions, mostly in otolaryngology and maxillofacial surgeries. The authors undertook this anatomical study in order to contribute a neurosurgical perspective, exploring the anterior and middle cranial fossa areas through this purely endoscopic transorbital trajectory. METHODS Anatomical dissections were performed in 10 human cadaveric heads (20 sides) using 0° and 30° endoscopes. A step-by-step description of the superior eyelid transorbital endoscopic route and surgically oriented classification are provided. RESULTS The authors' cadaveric prosection of this approach defined 3 modular routes that could be combined. Two corridors using bone removal lateral to the superior and inferior orbital fissures exposed the middle and anterior cranial fossa (lateral orbital corridors to the anterior and middle cranial base) to unveil the temporal pole region, lateral wall of the cavernous sinus, middle cranial fossa floor, and frontobasal area (i.e., orbital and recti gyri of the frontal lobe). Combined, these 2 corridors exposed the lateral aspect of the lesser sphenoid wing with the Sylvian region (combined lateral orbital corridor to the anterior and middle cranial fossa, with lesser sphenoid wing removal). The medial corridor, with extension of bone removal medially to the superior and inferior orbital fissure, afforded exposure of the opticocarotid area (medial orbital corridor to the opticocarotid area). CONCLUSIONS Along with its minimally invasive nature, the superior eyelid transorbital approach allows good visualization and manipulation of anatomical structures mainly located in the anterior and middle cranial fossae (i.e., lateral to the superior and inferior orbital fissures). The visualization and management of the opticocarotid region medial to the superior orbital fissure are more complex. Further studies are needed to prove clinical applications of this relatively novel surgical pathway.

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Transorbital Ultrasonographic Measurement of Optic Nerve Sheath Diameter for Intracranial Midline Shift in Patients with Head Trauma

Cited by 40 publications

References 33 publications

Quantification of Optic Nerve and Sheath Diameter by Transorbital Sonography: A Systematic Review and Metanalysis

Quantification of Optic Nerve and Sheath Diameter by Transorbital Sonography: A Systematic Review and Metanalysis

Describing a New Mechanism of Retinal Detachment Secondary to Ophthalmic Artery Vasospasm Following Subarachnoid Hemorrhage: An Experimental Study

Endoscopic transorbital superior eyelid approach: anatomical study from a neurosurgical perspective

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