Abstract
Objective To evaluate visual outcomes and potential complications for optic nerve decompression
using an endoscopic endonasal approach (EEA) for fibrous dysplasia.
Design Retrospective chart review of patients with fibrous dysplasia causing extrinsic compression
of the canalicular segment of the optic nerve that underwent an endoscopic endonasal
optic nerve decompression at the University of Pittsburgh Medical Center from 2010
to 2013.
Main Outcome Measures The primary outcome measure assessed was best-corrected visual acuity (BCVA) with
secondary outcomes, including visual field testing, color vision, and complications
associated with the intervention.
Results A total of four patients and five optic nerves were decompressed via an EEA. All
patients were symptomatic preoperatively and had objective findings compatible with
compressive optic neuropathy: decreased visual acuity was noted preoperatively in
three patients while the remaining patient demonstrated an afferent pupillary defect.
BCVA improved in all patients postoperatively. No major complications were identified.
Conclusion EEA for optic nerve decompression appears to be a safe and effective treatment for
patients with compressive optic neuropathy secondary to fibrous dysplasia. Further
studies are required to identify selection criteria for an open versus an endoscopic
approach.
Keywords
endoscopic - endonasal - optic nerve decompression - fibrous dysplasia
