Journal article
Combined transcranial-orbital approach for resection of optic nerve gliomas: a clinical and anatomical study
Ophthalmic plastic and reconstructive surgery, Vol.28(3), pp.184-191
05/2012
DOI: 10.1097/IOP.0b013e3182232395
PMID: 22581081
Abstract
To describe a combined transcranial-orbital approach for en bloc resection of optic nerve gliomas with preservation of the annulus of Zinn that minimizes recurrence and prevents postoperative paralytic ptosis. A retrospective, noncomparative, interventional case series. All patients who underwent optic nerve glioma resections using this technique with the authors between 1994 and 2010. A transcranial-orbital approach is used to resect the intracranial segment of the optic nerve glioma from 2 mm anterior to the chiasm to the posterior extent of annulus of Zinn. The proximal transected edge of the nerve is examined intraoperatively for tumor margin clearance. Through a superior orbitotomy exposure, the entire retrobulbar segment of the tumor is transected from the globe to the annulus of Zinn. A simulation of the procedure in a cadaver and en bloc resection of the orbital apex are performed to demonstrate the subdural plane of dissection within the annulus of Zinn. Postoperative outcome measures include: health of the ipsilateral globe, paralytic ptosis, postoperative complications, and tumor recurrence. Eleven patients underwent resection of optic nerve gliomas using this technique. No patients had tumor recurrence or developed postoperative paralytic ptosis. The combined transcranial-orbital approach with preservation of the annulus of Zinn is a safe and effective way to remove optic nerve gliomas and ensure tumor clearance while avoiding paralytic ptosis.
Details
- Title: Subtitle
- Combined transcranial-orbital approach for resection of optic nerve gliomas: a clinical and anatomical study
- Creators
- Erin M Shriver - Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, Florida 33136, USAJohn RaghebDavid T Tse
- Resource Type
- Journal article
- Publication Details
- Ophthalmic plastic and reconstructive surgery, Vol.28(3), pp.184-191
- Publisher
- United States
- DOI
- 10.1097/IOP.0b013e3182232395
- PMID
- 22581081
- ISSN
- 0740-9303
- eISSN
- 1537-2677
- Language
- English
- Date published
- 05/2012
- Academic Unit
- Otolaryngology; Ophthalmology and Visual Sciences
- Record Identifier
- 9983979910002771
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