Paredes Igor, Alén José Antonio Fernandez, García Alfredo, García Esther, Lagares Alfonso
Departments of Neurosurgery, University Hospital 12 de Octubre, Avenida de Cordoba SN, Madrid, Spain.
Departments of Otorhinolaryngology, University Hospital 12 de Octubre, Avenida de Cordoba SN, Madrid, Spain.
Surg Neurol Int. 2020 May 2;11:90. doi: 10.25259/SNI_11_2020. eCollection 2020.
Meningiomas of the optic sheath have been traditionally treated with radiotherapy, among other reasons, because of the poor results in terms of visual preservation of the open surgical approaches.
Two cases of optic nerve meningioma were operated through an endoscopic endonasal expanded approach due to rapidly progressing visual deterioration and doubtful diagnosis. In the first case an exclusively bone decompression was performed. In the second one a partial resection of the intradural portion and complete opening of the dural sheath was undertaken. In both cases visual acuity remained stable without further treatment for the 2 years follow up.
Endoscopic endonasal decompression of the optic nerve by removal of the optic canal and opening of the optic sheath is safe. This approach is feasible for optic sheath meningioma. This treatment might be considered as an option in patients with rapidly deteriorating visual acuity.
传统上，视神经鞘膜脑膜瘤采用放射治疗，原因之一是开放手术在视力保留方面效果不佳。
两例视神经脑膜瘤患者因视力迅速恶化且诊断存疑，通过鼻内镜扩大入路进行手术。第一例仅进行了骨减压。第二例对硬膜内部分进行了部分切除并完全打开了硬膜鞘。在这两例中，随访2年期间视力保持稳定，无需进一步治疗。
通过去除视神经管和打开视神经鞘进行鼻内镜下视神经减压是安全的。这种方法对视神经鞘膜脑膜瘤是可行的。对于视力迅速恶化的患者，可考虑将这种治疗作为一种选择。
