Optic nerve sheath fenestration : Current status in France and comparison of 6 different surgical approaches

Copyright © 2022 Elsevier Masson SAS. All rights reserved..

PURPOSE: Optic nerve sheath fenestration (ONSF) is a surgical procedure commonly performed in the Anglo-Saxon countries for the treatment of medically refractory idiopathic intracranial hypertension (IIH). We chose to compare 6 different trans-orbital surgical approaches to ONSF. We also desired to determine the number of optic nerve decompression procedures performed in France in 2019 and 2020.

METHODS: Four fresh frozen orbits were dissected at the University of Nice anatomy laboratory. We performed the following surgical approaches: (i) eyelid crease, (ii) lid-split, (iii) medial transconjunctival with medial rectus disinsertion, (iv) medial transconjunctival without rectus disinsertion, (v) lateral transconjunctival and (vi) lateral orbitotomy. For each surgical approach, we measured the distance between the incision and the optic nerve dura mater. We also extracted data from the French National PMSI (Programme de Médicalisation des Systèmes d' Information) database from January 2019 through December 2020 to determine the annual number of optic nerve decompression procedures.

RESULTS: The lid crease and medial transconjunctival approaches provided the shortest distance to the optic nerve (average 21mm and 24mm, respectively) and the lowest levels of difficulty compared to the other surgical routes. A total of 23 and 45 optic nerve decompressions were performed in France in 2019 and 2020, respectively. Among them, only 2 and 7 procedures, respectively, were performed through a trans-orbital approach.

CONCLUSION: Upper lid crease incision and medial transconjunctival approaches are the most direct and easiest surgical routes when performing an ONSF. We found that ONSF was rarely performed in France. We strongly recommend close cooperation between ophthalmologists, neurologists, neurosurgeons and interventional radiologists.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:46

Enthalten in:

Journal francais d'ophtalmologie - 46(2023), 2 vom: 21. Feb., Seite 137-147

Sprache:

Englisch

Beteiligte Personen:

Trucchi, L [VerfasserIn]
Cohen, M [VerfasserIn]
Nahon-Esteve, S [VerfasserIn]
Lagier, J [VerfasserIn]
Leal, C [VerfasserIn]
Almairac, F [VerfasserIn]
Chau, Y [VerfasserIn]
Sedat, J [VerfasserIn]
Bozzolo, E [VerfasserIn]
Themelin, A [VerfasserIn]
Mondot, L [VerfasserIn]
Baillif, S [VerfasserIn]
Martel, A [VerfasserIn]

Links:

Volltext

Themen:

Œdème papillaire
Fenestration des gaines du nerf optique
Hypertension intracrânienne idiopathique
Idiopathic intracranial hypertension
Journal Article
Lid crease approach
Nerf optique
Optic nerve
Optic nerve sheath fenestration
Papilledema
Transconjonctival
Transconjunctival
Voie de pli palpébral

Anmerkungen:

Date Completed 10.02.2023

Date Revised 10.02.2023

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.jfo.2022.07.014

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM350758115