Our Experience in Endoscopic Transnasal Optic Nerve Decompression

Abstract

INTRODUCTION: Traumatic optic neuropathy (TON), a severe complication following head injury, affects about 0.5% to 5% of patients with closed head injuries.¹ Visual acuity (VA) loss associated with TON can be partial or complete and temporary or permanent. Increased intracanalicular pressure after an injury is considered to be one of the main pathophysiological manifestations.² Mucoceles involving the Onodi cell and the sphenoidal sinus are rare, and optic nerve compression with decreased visual acuity may be the first presenting symptom.³.

Endonasal endoscopic optic nerve decompression is a safe and highly effective treatment to reduce the hydrostatic pressure on the optic nerve in cases of optic neuropathies of various etiologies.  This is to share our experience on transnasal endoscopic optic nerve decompression done for optic neuropathy due to traumatic optic neuropathy and non-traumatic optic neuropathy.

 CASE SERIES:

        A case series of three patients with traumatic optic neuropathy and one patient with non-traumatic optic neuropathy over a period of two years were studied. All four patients underwent endoscopic transnasal optic nerve decompression and surgical outcome in terms of visual recovery was observed.

DISCUSSION:

           Endoscopic transnasal optic nerve decompression is a minimally invasive , safe and efficient method of treatment for traumatic and non-traumatic optic neuropathy .⁴ Our experience also suggest that surgical intervention need to be considered as early as possible especially for traumatic cases to enhance visual recovery.