Microanatomic Study of the Optic Canal

Author(s):  
Zeferino Demartini ◽  
Simone Cristina Zanine
Keyword(s):  
2013 ◽  
Vol 74 (S 01) ◽  
Author(s):  
Francisco A. Filho ◽  
Omar Ramirez ◽  
Yancy Acosta ◽  
Luis Bonilla ◽  
Milton Rastelli ◽  
...  

Author(s):  
K. El-Bahy ◽  
Ashraf M. Ibrahim ◽  
Ibrahim Abdelmohsen ◽  
Hatem A. Sabry

Abstract Background Despite the recent advances in skull base surgery, microsurgical techniques, and neuroimaging, yet surgical resection of clinoidal meningiomas is still a major challenge. In this study, we present our institution experience in the surgical treatment of anterior clinoidal meningiomas highlighting the role of extradural anterior clinoidectomy in improving the visual outcome and the extent of tumor resection. This is a prospective observational study conducted on 33 consecutive patients with clinoidal meningiomas. The surgical approach utilized consisted of extradural anterior clinoidectomy, optic canal deroofing with falciform ligament opening in all patients. The primary outcome assessment was visual improvement and secondary outcomes were extent of tumor resection, recurrence, and postoperative complications. Results The study included 5 males and 28 females with mean age 49.48 ± 11.41 years. Preoperative visual deficit was present in 30 (90.9%) patients. Optic canal involvement was present in 24 (72.7%) patients, ICA encasement was in 16 (48.5%), and cavernous sinus invasion in 8 (24.2%). Vision improved in 21 patients (70%), while 6 patients (20%) had stationary course and 1 patient (3%) suffered postoperative new visual deterioration. Gross total resection was achieved in 24 patients (72.7%). The main factors precluding total removal were cavernous sinus involvement and ICA encasement. Mortality rate was 6.1%; mean follow-up period was 27 ± 13 months. Conclusions In this series, the use of extradural anterior clinoidectomy provided a favorable visual outcome and improved the extent of resection in clinoidal meningioma patients.


2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
J. Li ◽  
Q. S. Ran ◽  
B. Hao ◽  
X. Xu ◽  
H. F. Yuan

The endoscopic transethmoidal approach is favored for the lack of external scars, a wide field of view, and rapid recovery time. But the effect of iatrogenic trauma should not be ignored due to the removal of the uncinate process and anterior and posterior ethmoidal sinus. Anatomically, the optic nerve is close to the sphenoid sinus and Onodi cell. In order to preserve the uncinate process and ethmoidal sinus, we perform endoscopic transsphenoidal optic canal decompression (ETOCD), which is less invasive. However, the anatomy of sphenoid sinus is quite variable, and the anatomical landmarks are rare. Therefore, identifying the position of optic canal is particularly important during surgery. To solve this, we use a postprocessing technique to identify the position of the optic nerve and internal carotid artery on the sphenoid sinus wall. Our results find that VA in 13 patients improved, with a total improve rate of 59.1%. No serious complications were found. We also found that the length of optic canal is different and the medial wall of the optic canal was the longest (p<0.05). The middle section of the optic canal is the narrowest, which was significantly different from cranial mouth and orbital mouth (p<0.05). We assumed that decompression may not require removal of all medial wall. If we remove the length of the shortest wall on the medial wall of the optic canal, the compression may be relieved. Thus, ETOCD was a feasible, safe, effective, and less-invasive approach for patients with TON. The CT postprocessing imaging facilitated recognition of the optic canal during surgery. The decompression length of the medial wall may not need to be completely removed, especially near the cranial mouth.


2006 ◽  
Vol 104 (4) ◽  
pp. 621-624 ◽  
Author(s):  
Han Soo Chang ◽  
Masahiro Joko ◽  
Joon Suk Song ◽  
Kiyoshi Ito ◽  
Tatsushi Inoue ◽  
...  

✓Extradural unroofing of the optic canal and subsequent mobilization of the optic nerve is a useful technique in the surgical treatment of parasellar tumors; however, the drilling procedure itself is associated with the risk of optic nerve damage. A safer technique would certainly be beneficial. The ultrasonic bone curette is a device developed in Japan for safer bone removal. Its use in intradural anterior clinoidectomy and opening of the internal auditory meatus has been reported before. In this article the authors describe their experience in using this device for extradural unroofing of the optic canal in patients with parasellar tumors. Between March 2002 and November 2004, the aforementioned technique was used in the treatment of eight patients with parasellar tumors. After undertaking a frontotemporal craniotomy and orbital osteotomy, an ultrasonic bone curette was used to unroof the optic canal via an epidural approach; in five cases anterior clinoidectomy was added subsequently. Using an ultrasonic bone curette, unroofing of the optic canal was completed safely and required much less expertise than that required for standard drilling. The mortality and major morbidity rates were 0%. The visual function outcome was satisfactory, with the overall visual status improving in all seven patients in whom this symptom was present preoperatively. The ultrasonic bone curette makes the unroofing of the optic canal safer and easier, possibly improving the visual outcome of patients undergoing surgery for parasellar tumors.


2012 ◽  
Vol 61 (1) ◽  
pp. 33-36 ◽  
Author(s):  
Rashmi Ghai ◽  
Priti Sinha ◽  
Jaba Rajguru ◽  
Shilpi Jain ◽  
Satyam Khare ◽  
...  
Keyword(s):  

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