[Indications and surgical technique of the endonasal decompression of the optic nerve from an HNO medical viewpoint]

Abstract

Background: Acute and chronic progressive compression of the optic nerve is mostly caused by tumors and trauma. Special knowledge about the pathophysiological mechanisms of the nerve injury is necessary in all clinical disciplines managing optic nerve neuropathy. Hence, the technique, the indications and limitations of the endonasal endoscopic decompression procedure of the optic nerve will be described from an otolaryngological point of view.

Methods: On the basis of our own experience and the international literature, the indications and limitations of the endonasal-endoscopic approach for optic nerve decompression are described and critically reviewed.

Conclusions: The management of optic nerve neuropathy, especially in cases of severe trauma, remains controversial. Because the data of the present clinical trials are mostly not evidence based, an efficient transfer of relevant guidelines or recommendations into the clinical practice is difficult. Therefore, the indication for optic nerve decompression surgery, especially in traumatic optic nerve neuropathy, must be individualized.