Treatment of meningiomas involving the optic canal with endoscopic transnasal decompression of the optic nerve

Background Management of patients with optic nerve sheath meningiomas (ONSM) is controversial and the treatment strategy in this patient group is still up for discussion. Transnasal endoscopic orbital and optic nerve decompression aims to reduce the pressure in the orbit and on the optic nerve and thereby prevent vision loss. This article presents material from seven cases of transnasal endoscopic orbital decompressions. Methods The study design is a retrospective cohort study. The aim was to include all patients with a meningioma residing along the nerve sheath and who were operated using endoscopic transnasal decompression of the orbit and if needed the optic canal at Odense University Hospital. Data from the medical records were collected and pre- and postoperative eye examinations were compared. In addition, it was recorded whether there were complications to the procedure and whether additional treatments were given. Results In total, four women and three men were included in the study. Four out of seven patients experienced improvement in vision after the operation. One patient experienced unchanged vision and two patients experienced deterioration of vision after surgery. Conclusions The current report of seven patients with ONSM shows promising results for this surgical procedure as four out of seven patients experienced improvement in their vision at follow-up examinations. The two patients, who experienced deterioration of vision, already had severely reduced vision pre-operatively, which indicates that surgery should be considered before the vision becomes significantly reduced.