Optic nerve decompression via transethmoid and supraorbital approaches

Abstract

Visual loss following direct or indirect maxillofacial injuries may result from either reversible or irreversible optic nerve injuries. Optic nerve decompression may be required in select reversible injuries to the nerve, as well as for compressive neuropathy in fibrous dysplasia, osteopetrosis, and neoplasms of this region. Much controversy regarding ideal timing and surgical approach, steroid therapy, and the role of sheath decompression remains unresolved. Here, we discuss indications and surgical approaches for decompression, specifically the transethmoidal (external and transantral) and supraorbital craniotomy approaches. Visual loss following direct or indirect maxillofacial injuries may result from either reversible or irreversible optic nerve injuries. Optic nerve decompression may be required in select reversible injuries to the nerve, as well as for compressive neuropathy in fibrous dysplasia, osteopetrosis, and neoplasms of this region. Much controversy regarding ideal timing and surgical approach, steroid therapy, and the role of sheath decompression remains unresolved. Here, we discuss indications and surgical approaches for decompression, specifically the transethmoidal (external and transantral) and supraorbital craniotomy approaches.