Advertisement

Topics

Endoscopic transsphenoidal optic nerve decompression: an anatomical study.

Summary of "Endoscopic transsphenoidal optic nerve decompression: an anatomical study."


PURPOSE:
The endoscopic transnasal, transsphenoidal approach is considered by many a valid option to reach the sellar region and, in selected cases, to decompress the optic nerve. However, few data are available in literature about the real effectiveness of the procedure and the extent of nerve decompression needed to obtain a clinical result. The aim of this anatomical study was to describe the most important landmarks of the endoscopic transsphenoidal approach to the optic nerve.
METHODS:
Six silicone-injected cadaver heads were dissected via the endoscopic transnasal approach, performing a bilateral optic nerve decompression. The lateral optocarotid recess (OCR) and optic canal were identified in each case. Moreover, the relationship between the ophthalmic artery at its origin and the optic nerve was examined.
RESULTS:
Twelve decompressions of the optic nerve were performed, obtaining the following measurements: intercarotid distance 12 mm ± 1.5, median length of OCR 5 mm ± 1 and average length of optic nerve decompression 15 mm ± 2. The ophthalmic artery was observed emerging from the internal carotid artery (ICA) medially in six cases, ventrally in four cases and laterally in two cases.
CONCLUSION:
A wide optic nerve decompression may be obtained with transsphenoidal approach. However, the risk of ophthalmic artery injury seems to be more relevant than with supratentorial approaches, due to the intimate relationship between artery and nerve on its inferior surface. Knowledge of anatomical landmarks, such as lateral OCR and the position of the ophthalmic artery, is useful to prevent this injury.

Affiliation

Neurosurgery Department, Fondazione IRCCS Ospedale Maggiore Policlinico Ca' Granda Milano, via Chiossetto 7, 20122, Milan, Italy, marco.locatelli@policlinico.mi.it.

Journal Details

This article was published in the following journal.

Name: Surgical and radiologic anatomy : SRA
ISSN: 1279-8517
Pages:

Links

DeepDyve research library

PubMed Articles [22916 Associated PubMed Articles listed on BioPortfolio]

Endoscopic Endonasal Management of Orbital Pathologies.

Based on the anatomic relationship between sinonasal complex and orbit, endoscopic transnasal procedures could be a smart solution for approaching the medial orbital region. These techniques should be...

Compromised Optic Nerve Blood Flow and Autoregulation Secondary to Neural Degeneration.

To test the hypothesis that optic nerve head (ONH) blood flow (BF) and autoregulation compromise are consequences of optic nerve degeneration induced by surgical optic nerve transection (ONT).

Optic nerve involvement in childhood onset systemic lupus erythematosus: Three cases and a review of the literature.

The ocular system can be affected in systemic lupus erythematosus (SLE) in one third of patients. However, optic nerve involvement is relatively uncommon, but is more so in pediatric SLE patients, whe...

Endonasal endoscopic transsphenoidal chiasmapexy using a clival cranial base cranioplasty for visual loss from massive empty sella following macroprolactinoma treatment with bromocriptine: case report.

Visual deterioration after dopamine-agonist treatment of prolactinomas associated with empty sella syndrome and secondary optic apparatus traction is a rare event. Chiasmapexy has been described as a ...

134 Comparison of Extent of Tumor Resection and Endocrine Outcomes for Nonfunctioning Pituitary Adenomas of a Less Experienced Surgeon Using a Fully Endoscopic Transsphenoidal Surgery Technique to a Very Experienced Surgeon Using a Microscopic Transsphenoidal Surgical Technique.

The comparative efficacy of microscopic and fully endoscopic transsphenoidal surgery for pituitary adenomas has not been well studied despite the adoption of fully endoscopic surgery by many pituitary...

Clinical Trials [1699 Associated Clinical Trials listed on BioPortfolio]

Neurotomy of Optic Nerve in Non-Arthritic Anterior Ischemic Optic Neuropathy

Non-arthritic anterior ischemic optic neuropathy is the most common cause of sudden visual loss due to optic nerve involvement in patients above 50 years old. As this problem can be consid...

Amiloride Hydrochlorothiazide as Treatment of Acute Inflammation of the Optic Nerve

Following acute inflammation of the optic nerve region, as commonly seen in multiple sclerosis patients, the optic nerve often undergoes atrophy, thus representing permanent damage. Data f...

Optic Nerve Compliance Study

Chronic glaucoma is one of the leading causes of blindness and visual loss in the developed world. It is a condition where long term exposure to high eye pressures (intra-ocular pressure) ...

Optic Nerve Ultrasound in Severe Traumatic Injury

Prospective study of diagnostic accuracy of optic nerve sheath diameter measurement (index study) in traumatic brain injury with simultaneous invasive intracranial pressure monitoring as t...

Treatment of Optic Neuritis With Erythropoietin: a Randomised, Double-blind, Placebo-controlled Trial

This clinical trial aims at preventing visual dysfunction and optic nerve degeneration associated with autoimmune optic neuritis by systemic i.v. administration of 33.000 IU erythropoietin...

Medical and Biotech [MESH] Definitions

Atrophy of the optic disk which may be congenital or acquired. This condition indicates a deficiency in the number of nerve fibers which arise in the RETINA and converge to form the OPTIC DISK; OPTIC NERVE; OPTIC CHIASM; and optic tracts. GLAUCOMA; ISCHEMIA; inflammation, a chronic elevation of intracranial pressure, toxins, optic nerve compression, and inherited conditions (see OPTIC ATROPHIES, HEREDITARY) are relatively common causes of this condition.

Conditions which produce injury or dysfunction of the second cranial or optic nerve, which is generally considered a component of the central nervous system. Damage to optic nerve fibers may occur at or near their origin in the retina, at the optic disk, or in the nerve, optic chiasm, optic tract, or lateral geniculate nuclei. Clinical manifestations may include decreased visual acuity and contrast sensitivity, impaired color vision, and an afferent pupillary defect.

Benign and malignant neoplasms that arise from the optic nerve or its sheath. OPTIC NERVE GLIOMA is the most common histologic type. Optic nerve neoplasms tend to cause unilateral visual loss and an afferent pupillary defect and may spread via neural pathways to the brain.

The 2nd cranial nerve. The optic nerve conveys visual information from the retina to the brain. The nerve carries the axons of the retinal ganglion cells which sort at the optic chiasm and continue via the optic tracts to the brain. The largest projection is to the lateral geniculate nuclei; other important targets include the superior colliculi and the suprachiasmatic nuclei. Though known as the second cranial nerve, it is considered part of the central nervous system.

The portion of the optic nerve seen in the fundus with the ophthalmoscope. It is formed by the meeting of all the retinal ganglion cell axons as they enter the optic nerve.

Quick Search
Advertisement
 


DeepDyve research library

Relevant Topic

Neurology - Central Nervous System (CNS)
Alzheimer's Disease Anesthesia Anxiety Disorders Autism Bipolar Disorders Dementia Epilepsy Multiple Sclerosis (MS) Neurology Pain Parkinson's Disease Sleep Disorders Neurology is the branch of me...


Searches Linking to this Article