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Hee-Jeong Lee, Doo-Sik Kong; Endoscopic Optic Canal Decompression For Compressive Optic Neuropathy. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3899.
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Compressive optic neuropathy rarely occurs from traumatic or non-traumatic events. The aim of this study was to determine the endoscopic anatomy of the orbital apex and to evaluate the optimal target for endoscopic optic nerve decompression.
We experienced four cases of endoscopic optic nerve decompression, including two traumatic optic neuropathies and two fibrous dysplasias compressing the optic canal. For these lesions, the major concern in the treatment was involved removing the bony structures around the optic nerve. We reviewed our surgical series and assessed the outcome of endoscopic optic nerve decompression.
All compressive lesions were effectively removed using an endoscopic endonasal route. Following endoscopic optic nerve decompression, two patients had markedly improved visual acuity and field, one patient had improved visual fields without a change in visual acuity, and the other patient showed improved visual acuity. There were no operative complications. In all cases, adequate exposure of the intracanalicular portion of the optic nerve was essential for effective decompression of the optic nerve. To achieve this goal, decompression of the roof as well as medial wall of the optic intracanalicular portion was critical and it provided adequate decompression of major lesions.
Endoscopic optic canal decompression is a minimally invasive, safe, and efficient treatment for compressive optic neuropathy of any origin. Adequate decompression of the roof of the intracanalicular portion at the optic canal is a major step in achieving good outcome in endoscopic optic canal decompression.
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