Abstract
Optic nerve decompression is required to recover vision that has been impaired by compression of the optic nerve as a result of injuries to the face or head, or neoplasm in the orbit. There are fundamentally three routes to access the optic canal: through the skull, the orbit, or the nasal cavity. As an otolaryngologist who regularly performs endoscopic sinus surgeries, access through the nasal cavity using an endoscope is a preferred route. Moreover, endoscopic endonasal optic nerve decompression has advantages over the other two routes, as it is minimally invasive with no skin incision on the face and, in addition, allows visualization of the optic canal and the optic nerve in greater detail. A search of the literature published in Japan found only a few reports of endoscopic endonasal optic nerve decompression, all of which were performed to alleviate visual dysfunction caused by fracture of the optic canal. Here we report a case in which vision impairment due to a neoplastic lesion was treated by endoscopic endonasal optic nerve decompression. A 44-year-old man suffered deteriorated vision due to optic canal destruction by a paranasal sinus cyst. Emergency endoscopic optic nerve decompression was performed through the nasal cavity, and the patient exhibited full recovery of visual functions. We suggest that endoscopic endonasal optic nerve decompression is minimally invasive and efficacious in treating optic nerve disorder not only by trauma, but also by neoplasm in the orbit.
