OPTIC-NERVE DECOMPRESSION FOR COMPRESSIVE NEUROPATHY SECONDARY TO NEOPLASIA

Objective: To evaluate the outcome of extracranial optic nerve decompr ession in patients with compressive optic neuropathy secondary to intr acranial, paranasal sinus, or orbital neoplastic processes. Design: A retrospective chart review and clinical followup of patients who under went optic nerve decompression. Setting: Tertiary care referral center . Patients: During an 8-year period, 95 extracranial optic nerve decom pressions were performed by one of us (M.P.J.) for optic neuropathy re sulting from traumatic, inflammatory, infectious, iatrogenic, neoplast ic, and idiopathic processes. Thirty patients with compressive optic n europathy secondary to histopathologically confirmed tumors were ident ified. Intervention: Optic nerve decompression via external ethmoidect omy approach. Result: Twenty (67%) of 30 patients showed improvement i n vision. Improvement in 17 of the 20 patients has been stable. Seven patients (23%) showed no improvement but there was no further worsenin g of vision after surgery. In 3 patients (10%) vision deteriorated fol lowing surgery. Conclusion: Extracranial optic nerve decompression may be considered for the preservation or improvement of vision in select ed patients with compressive optic neuropathy from neoplasms.