Extracranial optic nerve decompression: A 10-year review of 92 patients

Over a 10-year period the authors have performed 92 transethmoidal optic ne rve decompressions for the treatment of visual loss due to various patholog ical processes, including 45 cases of trauma 32 cases of neoplasm, 2 cases of bacterial pansinusitis, 5 cases of sphenoethmoidal mucocele, 4 cases of aspergillosis (all were immunocompetent patients), 2 cases of Wegener's gra nulomatosis, and 2 cases of sarcoidosis. Forty-eight patients (52%) had pre operative visual acuity of light perception or better, and in 44 patients ( 48%) the preoperative vision was no light perception. Sixty-five patients ( 71%) achieved improvement of vision postoperatively. Twenty-four patients ( 26%) had no change in vision and 3 patients (3%) had deterioration of visio n after surgery. The mean percentage of improvement was 40.7% +/- 6.9% in t he trauma group, 61.6% +/- 23.2% in the neoplasm group, 66.4% +/- 25.2% in the infectious/mucocele group, and only one patient in the inflammatory gro up had slight visual improvement from no light perception to counting finge rs. Extracranial optic nerve decompression can result in the improvement of visual function in some patients with optic nerve injury from various caus es.