{"id":"16d4a7da-c615-4acf-a01e-5c1ad405bb84","slug":"optic-nerve-sheath-meningioma-endoscopic-endonasal-surgical-management","title":"Optic nerve sheath meningioma endoscopic endonasal surgical management","authors":["Igor Paredes","José Antonio Fernandez Alén","Alfredo García","Esther García","Alfonso Lagares"],"abstract":"Background: Meningiomas of the optic sheath have been traditionally treated with radiotherapy, among other reasons, because of the poor results in terms of visual preservation of the open surgical approaches. Case Description: Two cases of optic nerve meningioma were operated through an endoscopic endonasal expanded approach due to rapidly progressing visual deterioration and doubtful diagnosis. In the first case an exclusively bone decompression was performed. In the second one a partial resection of the intradural portion and complete opening of the dural sheath was undertaken. In both cases visual acuity remained stable without further treatment for the 2 years follow up. Conclusions: Endoscopic endonasal decompression of the optic nerve by removal of the optic canal and opening of the optic sheath is safe. This approach is feasible for optic sheath meningioma. This treatment might be considered as an option in patients with rapidly deteriorating visual acuity. 2) 0:31 – Preoperative MRI 3) 1:26 – Sphenoidotomy 4) 1:40 – Drilling of the optic canal 5) 2:04 – Roof of the optic canal is removed 6) 2:26 – Neronavigation confirms that the bony decompression is completed 7) 2:33 – Postsurgical images of Case 1 9) 3:25 – Preoperative MRI 10) 3:58 – Drilling of the optic canal 11) 4:30 – Roof of the optic canal 12) 5:03 – Floor of the canal/Optic Strut 13) 5:25 – Dura opening 14) 5:28 – Olfactory nerve 15) 5:50 – Optic sheath opening 16) 6:14 – Tumor removal 17) 6:43 – Optic nerve 18) 7:21 – Ophthalmic Artery 19) 7:50 – Final view 22) 8:25 – Nasoseptal flap 24) 8:39 – Tisseal® and final appearance 25) 8:50 – Postsurgical images of Case 2 26) 9:21 – Conclusion The authors certify that they have obtained all appropriate patient consent. There are no conflicts of interest.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/placeholders/specialty/neuroendoscopy.png","publishDate":"2020-05-02T00:00:00.000Z","doi":"10.25259/SNI_11_2020","categories":["Neuroendoscopy","Video Abstract"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2020/05/9995/SNI-11-90.pdf"}