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Exostosis of the optic canal in a child--a rare diagnosis in a paediatric ear, nose and throat setting: a case report.

Urík M, Šlapák I, Pavlovská D, Prívarová E - J Med Case Rep (2014)

Bottom Line: We describe the case of a 14-year-old Caucasian girl with a gradual deterioration of vision in her right eye.It is a gentle and minimally invasive surgical technique.Interdisciplinary cooperation, especially with the eye doctor and radiologist, is required in these cases.

View Article: PubMed Central - PubMed

Affiliation: Department of Paediatric Otorhinolaryngology, Faculty of Medicine, Masaryk University and University Hospital Brno 1, Cernopolni 9, 61300, Brno, Czech Republic. docttor.urik@gmail.com.

ABSTRACT

Introduction: Optic nerve compression is an uncommon disorder leading to deterioration or complete loss of vision.

Case presentation: We describe the case of a 14-year-old Caucasian girl with a gradual deterioration of vision in her right eye. Using modern imaging techniques and endonasal endoscopic surgery, we identified the cause and removed the pathology.

Conclusions: The cause of optic nerve compression was a rare exostosis in the optic canal. An endonasal endoscopic approach is the optimal choice for management of optic nerve pathologies. It is a gentle and minimally invasive surgical technique. Interdisciplinary cooperation, especially with the eye doctor and radiologist, is required in these cases.

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Endoscopic endonasal surgery – the view after eradication of exostosis. Abbreviations: o.n., optic nerve; s, suction.
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Fig8: Endoscopic endonasal surgery – the view after eradication of exostosis. Abbreviations: o.n., optic nerve; s, suction.

Mentions: Endonasal endoscopic decompression of her optic nerve was performed (Figures 7 and 8). Medial and posterior ethmoidectomy and sphenoidotomy were performed under general anaesthesia using endoscopic techniques; subsequently bone was removed from the medial wall of her orbit and her optic canal was gradually approached. The optic canal narrowing was seen about 13mm behind the tip of her orbit, which enlarged again in the direction towards the chiasm. A part of the bone in the narrowed area was removed using punches, shaver and diamond bur to release the optic nerve. The histology report described the bone formation as a lamellar compact bone. She was subsequently referred to the care of an ophthalmologist and underwent regular eye examinations. Her condition markedly improved, with persistent central scotoma in her right eye.Figure 7


Exostosis of the optic canal in a child--a rare diagnosis in a paediatric ear, nose and throat setting: a case report.

Urík M, Šlapák I, Pavlovská D, Prívarová E - J Med Case Rep (2014)

Endoscopic endonasal surgery – the view after eradication of exostosis. Abbreviations: o.n., optic nerve; s, suction.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4307678&req=5

Fig8: Endoscopic endonasal surgery – the view after eradication of exostosis. Abbreviations: o.n., optic nerve; s, suction.
Mentions: Endonasal endoscopic decompression of her optic nerve was performed (Figures 7 and 8). Medial and posterior ethmoidectomy and sphenoidotomy were performed under general anaesthesia using endoscopic techniques; subsequently bone was removed from the medial wall of her orbit and her optic canal was gradually approached. The optic canal narrowing was seen about 13mm behind the tip of her orbit, which enlarged again in the direction towards the chiasm. A part of the bone in the narrowed area was removed using punches, shaver and diamond bur to release the optic nerve. The histology report described the bone formation as a lamellar compact bone. She was subsequently referred to the care of an ophthalmologist and underwent regular eye examinations. Her condition markedly improved, with persistent central scotoma in her right eye.Figure 7

Bottom Line: We describe the case of a 14-year-old Caucasian girl with a gradual deterioration of vision in her right eye.It is a gentle and minimally invasive surgical technique.Interdisciplinary cooperation, especially with the eye doctor and radiologist, is required in these cases.

View Article: PubMed Central - PubMed

Affiliation: Department of Paediatric Otorhinolaryngology, Faculty of Medicine, Masaryk University and University Hospital Brno 1, Cernopolni 9, 61300, Brno, Czech Republic. docttor.urik@gmail.com.

ABSTRACT

Introduction: Optic nerve compression is an uncommon disorder leading to deterioration or complete loss of vision.

Case presentation: We describe the case of a 14-year-old Caucasian girl with a gradual deterioration of vision in her right eye. Using modern imaging techniques and endonasal endoscopic surgery, we identified the cause and removed the pathology.

Conclusions: The cause of optic nerve compression was a rare exostosis in the optic canal. An endonasal endoscopic approach is the optimal choice for management of optic nerve pathologies. It is a gentle and minimally invasive surgical technique. Interdisciplinary cooperation, especially with the eye doctor and radiologist, is required in these cases.

Show MeSH
Related in: MedlinePlus