- Departments of Neurosurgery, University Hospital 12 de Octubre, Avenida de Cordoba SN, Madrid, Spain.
- Departments of Otorhinolaryngology, University Hospital 12 de Octubre, Avenida de Cordoba SN, Madrid, Spain.
Correspondence Address:
Igor Paredes
Departments of Neurosurgery, University Hospital 12 de Octubre, Avenida de Cordoba SN, Madrid, Spain.
DOI:10.25259/SNI_11_2020
Copyright: © 2020 Surgical Neurology International This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.How to cite this article: Igor Paredes, José Antonio Fernandez Alén, Alfredo GarcÃa, Esther GarcÃa, Alfonso Lagares. Optic nerve sheath meningioma endoscopic endonasal surgical management. 02-May-2020;11:90
How to cite this URL: Igor Paredes, José Antonio Fernandez Alén, Alfredo GarcÃa, Esther GarcÃa, Alfonso Lagares. Optic nerve sheath meningioma endoscopic endonasal surgical management. 02-May-2020;11:90. Available from: https://surgicalneurologyint.com/?post_type=surgicalint_articles&p=9995
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.
Keywords: Optic Sheath Meningioma, Endoscopic Endonasal Expanded Approach, Optic Nerve Decompression
Annotations[1-7]
1) 0:05 – Case 1
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
8) 2:54 – Case 2
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
20) 7:56 – Tisseal®
21) 8:00 – Duragen®
22) 8:25 – Nasoseptal flap
23) 8:36 – Surgicel®
24) 8:39 – Tisseal® and final appearance
25) 8:50 – Postsurgical images of Case 2
26) 9:21 – Conclusion
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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