An evolving perspective of endoscopic transnasal optic canal decompression for traumatic optic neuropathy in clinic

Abstract

Traumatic optic neuropathy (TON) is a serious complication of craniofacial trauma, which damages the optic nerve indirectly and leads to dysfunction of visual acuity. The clinical intervention for a patient with TON includes optic canal decompression (with or without steroids), treatment with corticosteroids alone, or observation only. Currently, there is a controversy among clinicians as to which treatment is optimal. An increasing number of retrospective studies have unveiled that patients could experience significant improvement in visual acuity after optic canal decompression surgery, particularly endoscopic transnasal/transethmosphenoid optic canal decompression (ETOCD), either with or without corticosteroids. In this review, we discuss the evolving perspective on surgical treatment, specifically ETOCD, for the management of patients with TON and focus mainly on the therapeutic efficacy, safety, and resulting prognosis in the clinic.

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Funding

This work was supported by the grants of the Major Research and Development Project of Zhejiang Province (No. 2017C03021) and Medical Health Science and Technology Project of Zhejiang Province (No. 2018ZD018).

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Correspondence to Jianmin Zhang or Wei Yan.

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Lin, J., Hu, W., Wu, Q. et al. An evolving perspective of endoscopic transnasal optic canal decompression for traumatic optic neuropathy in clinic. Neurosurg Rev 44, 19–27 (2021). https://doi.org/10.1007/s10143-019-01208-y

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Keywords

  • Traumatic optic neuropathy
  • Optic canal decompression
  • Endoscopy
  • Transnasal
  • Transethmosphenoid
  • Review