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A Modified Surgical Procedure for Endoscopic Optic Nerve Decompression for the Treatment of Traumatic Optic Neuropathy

BACKGROUND: Although the endoscopic anterior-to-posterior technique offers many advantages, the long-term effects of the iatrogenic trauma (removal of the uncinate process and anterior ethmoidal sinus) resulting from the complete ethmoidectomy procedure used to gain full access to the optic nerve ca...

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Autores principales: Chen, Fenghong, Zuo, Kejun, Feng, Shaoyan, Guo, Jiebo, Fan, Yunping, Shi, Jianbo, Li, Huabin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4083528/
https://www.ncbi.nlm.nih.gov/pubmed/25006562
http://dx.doi.org/10.4103/1947-2714.134372
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author Chen, Fenghong
Zuo, Kejun
Feng, Shaoyan
Guo, Jiebo
Fan, Yunping
Shi, Jianbo
Li, Huabin
author_facet Chen, Fenghong
Zuo, Kejun
Feng, Shaoyan
Guo, Jiebo
Fan, Yunping
Shi, Jianbo
Li, Huabin
author_sort Chen, Fenghong
collection PubMed
description BACKGROUND: Although the endoscopic anterior-to-posterior technique offers many advantages, the long-term effects of the iatrogenic trauma (removal of the uncinate process and anterior ethmoidal sinus) resulting from the complete ethmoidectomy procedure used to gain full access to the optic nerve canal is unknown, and sequelae such as nasal synechia and sinusitis should not be ignored. AIMS: The aim of our study is to develop a less invasive procedure for endoscopic optic nerve decompression. MATERIALS AND METHODS: We proposed a modified trans-sphenoidal surgical procedure for endoscopic optic nerve decompression in five patients with traumatic optic neuropathy (TON), all with high sphenoidal pneumatisation and without Onodi cellulae. RESULTS: After performing a direct sphenoidotomy through the natural ostium of the sphenoid sinus rather than a complete ethmo-sphnoidectomy, we found that the modified approach provided adequate access to the optic nerve canal and the apex using a 45° angled endoscope. Successful decompression of the canal optic nerve was performed trans-sphenoidally in all five TON patients using an angled endoscope. No surgical complications occurred, and none of the patients suffered from anterior ethmoidal sinus or skull base damage. CONCLUSIONS: The modified trans-sphenoidal approach is a feasible, safe, effective, and minimally invasive approach for TON patients with high sphenoidal pneumatisation and without supersphenoid-ethmoid cellulae.
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spelling pubmed-40835282014-07-08 A Modified Surgical Procedure for Endoscopic Optic Nerve Decompression for the Treatment of Traumatic Optic Neuropathy Chen, Fenghong Zuo, Kejun Feng, Shaoyan Guo, Jiebo Fan, Yunping Shi, Jianbo Li, Huabin N Am J Med Sci Original Article BACKGROUND: Although the endoscopic anterior-to-posterior technique offers many advantages, the long-term effects of the iatrogenic trauma (removal of the uncinate process and anterior ethmoidal sinus) resulting from the complete ethmoidectomy procedure used to gain full access to the optic nerve canal is unknown, and sequelae such as nasal synechia and sinusitis should not be ignored. AIMS: The aim of our study is to develop a less invasive procedure for endoscopic optic nerve decompression. MATERIALS AND METHODS: We proposed a modified trans-sphenoidal surgical procedure for endoscopic optic nerve decompression in five patients with traumatic optic neuropathy (TON), all with high sphenoidal pneumatisation and without Onodi cellulae. RESULTS: After performing a direct sphenoidotomy through the natural ostium of the sphenoid sinus rather than a complete ethmo-sphnoidectomy, we found that the modified approach provided adequate access to the optic nerve canal and the apex using a 45° angled endoscope. Successful decompression of the canal optic nerve was performed trans-sphenoidally in all five TON patients using an angled endoscope. No surgical complications occurred, and none of the patients suffered from anterior ethmoidal sinus or skull base damage. CONCLUSIONS: The modified trans-sphenoidal approach is a feasible, safe, effective, and minimally invasive approach for TON patients with high sphenoidal pneumatisation and without supersphenoid-ethmoid cellulae. Medknow Publications & Media Pvt Ltd 2014-06 /pmc/articles/PMC4083528/ /pubmed/25006562 http://dx.doi.org/10.4103/1947-2714.134372 Text en Copyright: © North American Journal of Medical Sciences http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Chen, Fenghong
Zuo, Kejun
Feng, Shaoyan
Guo, Jiebo
Fan, Yunping
Shi, Jianbo
Li, Huabin
A Modified Surgical Procedure for Endoscopic Optic Nerve Decompression for the Treatment of Traumatic Optic Neuropathy
title A Modified Surgical Procedure for Endoscopic Optic Nerve Decompression for the Treatment of Traumatic Optic Neuropathy
title_full A Modified Surgical Procedure for Endoscopic Optic Nerve Decompression for the Treatment of Traumatic Optic Neuropathy
title_fullStr A Modified Surgical Procedure for Endoscopic Optic Nerve Decompression for the Treatment of Traumatic Optic Neuropathy
title_full_unstemmed A Modified Surgical Procedure for Endoscopic Optic Nerve Decompression for the Treatment of Traumatic Optic Neuropathy
title_short A Modified Surgical Procedure for Endoscopic Optic Nerve Decompression for the Treatment of Traumatic Optic Neuropathy
title_sort modified surgical procedure for endoscopic optic nerve decompression for the treatment of traumatic optic neuropathy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4083528/
https://www.ncbi.nlm.nih.gov/pubmed/25006562
http://dx.doi.org/10.4103/1947-2714.134372
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