Endoscopic trans-ethmo-sphenoidal optic nerve decompression for traumatic optic neuropathy: Case series and review

Abstract

Objective: To assess the visual outcome after endoscopic, endonasal trans-ethmo-sphenoidal optic nerve decompression in patients with traumatic optic neuropathy. Materials and methods: Prospective study, at tertiary referral center. Study included 12 patients with post-traumatic indirect unilateral optic nerve injury, not responding to medical management with methylprednisolone. These patients underwent optic nerve decompression via trans-ethmo-sphenoidal route using nasal endoscope. Main outcome measure was postoperative visual acuity. Results: Out of the 12 cases of traumatic optic neuropathy (TON) operated upon, nine had good visual outcome. Conclusion: The endoscopic endonasal trans-sphenoidal approach can decompress the traumatized and swollen optic nerve with excellent visualization of the orbital apex and optic canal, without the morbidity associated with brain retraction as in the conventional transcranial decompression.