Bilateral Orbital and Optic Nerve Endoscopic Endonasal Decompression for Nonspecific Inflammatory Orbital Disease: Case Report

Abstract

Background Endoscopic endonasal optic nerve decompression (EEOND) is indicated in traumatic and endocrine orbitopathies as well as in idiopathic intracranial hypertension.

Case We present a patient with bilateral nonspecific inflammatory orbitopathy (NSIO) and optic nerve compression presenting with acute severe visual loss. Bilateral orbital and optic nerve decompression was performed as an emergency procedure with a favorable ophthalmological result.

Conclusion EEOND is an effective and safe technique in acute orbitopathies and should be taken in consideration in atypical clinical settings causing severe acute visual loss.

Keywords

minimally invasive - image guidance - transnasal approach - endoscopy

• References

• 1 Morax S, Ben Ayed H. [Orbital decompression for dysthyroid orbitopathy: a review of techniques and indications]. J Fr Ophtalmol 2004; 27: 828-844
• 2 Chen C, Selva D, Floreani S, Wormald PJ. Endoscopic optic nerve decompression for traumatic optic neuropathy: an alternative. Otolaryngol Head Neck Surg 2006; 135: 155-157
• 3 Karaki M, Kobayashi R, Mori N. Removal of an orbital apex hemangioma using an endoscopic transethmoidal approach: technical note. Neurosurgery 2006; 59 (1, Suppl 1) ONES159-ONES160 , discussion E159–E160
• 4 Yoshimura K, Kubo S, Yoneda H, Hasegawa H, Tominaga S, Yoshimine T. Removal of a cavernous hemangioma in the orbital apex via the endoscopic transnasal approach: a case report. Minim Invasive Neurosurg 2010; 53: 77-79
• 5 Koc K, Anik I, Altintas O, Ceylan S. Endoscopic optic nerve decompression for idiopathic intracranial hypertension in two cases: case report. Minim Invasive Neurosurg 2008; 51: 72-75
• 6 Patrocínio JA, Patrocínio LG, Júnior FB, da Cunha AR. Endoscopic decompression of the optic nerve in pseudotumor cerebri. Auris Nasus Larynx 2005; 32: 199-203
• 7 Dallan I, Seccia V, Lenzi R , et al. Transnasal approach to the medial intraconal space: anatomic study and clinical considerations. Minim Invasive Neurosurg 2010; 53: 164-168
• 8 Düz B, Secer HI, Gonul E. Endoscopic approaches to the orbit: a cadaveric study. Minim Invasive Neurosurg 2009; 52: 107-113
• 9 Locatelli M, Caroli M, Pluderi M , et al. Endoscopic transsphenoidal optic nerve decompression: an anatomical study. Surg Radiol Anat 2011; 33: 257-262
• 10 Smith JR, Rosenbaum JT. A role for methotrexate in the management of non-infectious orbital inflammatory disease. Br J Ophthalmol 2001; 85: 1220-1224
• 11 Espinoza GM. Orbital inflammatory pseudotumors: etiology, differential diagnosis, and management. Curr Rheumatol Rep 2010; 12: 443-447 Review