Harini V, Balsamy Mahalakshmiy
Department of Radiodiagnosis, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India.
Department of Ophthalmology, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India.
J Pharm Bioallied Sci. 2025 Apr-Jun;17(2):97-99. doi: 10.4103/jpbs.jpbs_1003_25. Epub 2025 Jul 23.
We describe an unusual instance of a juvenile with proptosis and progressive one sided vision loss. Radiological imaging showed an intraorbital lesion indicative of optic nerve sheath meningioma (ONSM). An endoscopic endonasal surgical method was used for tumor excision, given the medial orbital position of the lesion and growing vision loss. Optimal exposure and decompression were obtained using careful dissection and intraoperative navigation. The patient had visual improvement in follow-up evaluations; the postoperative period was quiet. This instance underlines the value of endoscopic endonasal surgery in some individuals and contributes to the limited research on pediatric ONSM. Endoscopic techniques provide better access to the medial orbit with the least morbidity as compared to conventional treatments. Although surgery could be better in young patients with quickly advancing symptoms or in situations with secondary lesions, radiation is still the norm for adult ONSMs. Even in physically difficult environments, our study corroborates the results from previous literature suggesting the viability and safety of this strategy in pediatric populations. Particularly when visual function is at stake, endoscopic endonasal surgery is a feasible and efficient therapy choice for children with ONSM. Favorable results depend on early diagnosis and tailored surgical planning.
我们描述了一例罕见的患有眼球突出和进行性单侧视力丧失的青少年病例。影像学检查显示眶内病变提示视神经鞘膜瘤(ONSM)。鉴于病变位于眼眶内侧且视力逐渐丧失,采用了鼻内镜下经鼻手术方法切除肿瘤。通过仔细解剖和术中导航获得了最佳暴露和减压效果。患者在随访评估中视力有所改善;术后情况平稳。该病例强调了鼻内镜下经鼻手术在某些个体中的价值,并为小儿ONSM的有限研究做出了贡献。与传统治疗方法相比,内镜技术能够以最低的发病率更好地进入眼眶内侧。尽管对于症状迅速进展的年轻患者或伴有继发性病变的情况,手术可能效果更佳,但放射治疗仍是成人ONSM的常规治疗方法。即使在实际操作困难的环境中,我们的研究也证实了先前文献的结果,表明该策略在儿科人群中具有可行性和安全性。特别是当视觉功能受到威胁时,鼻内镜下经鼻手术对于患有ONSM的儿童是一种可行且有效的治疗选择。良好的结果取决于早期诊断和量身定制的手术规划。