Long‐term Outcomes Following Endoscopic Transnasal Surgery for Optic Neuropathy Due to Craniofacial Fibrous Dysplasia
Objective To investigate the feasibility of endoscopic transnasal optic canal decompression (ETOCD) guided by a navigation surgical system (NSS) for vision recovery in patients with compressive optic neuropathy (CON) caused by craniofacial fibrous dysplasia (CFD), and to explore the underlying cause...
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| Veröffentlicht in: | The Laryngoscope 2023-08, Vol.133 (8), p.1857-1866 |
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| container_title | The Laryngoscope |
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| creator | Wang, Min Zhu, Senmiao Shen, Bingyan Fang, Yenan Xie, Qiqi Dai, Qin Chen, Ziwen Li, Xinyu Wu, Wencan |
| description | Objective
To investigate the feasibility of endoscopic transnasal optic canal decompression (ETOCD) guided by a navigation surgical system (NSS) for vision recovery in patients with compressive optic neuropathy (CON) caused by craniofacial fibrous dysplasia (CFD), and to explore the underlying cause of visual impairment.
Methods
All patients underwent unilateral NSS‐guided ETOCD and were followed up periodically for at least six months. Paired sample t‐test and Pearson correlation analyses were used to compare continuous variables of the visual outcomes at the final review. A histopathological test of abnormal bone specimens was performed postoperatively.
Results
Thirty‐four patients were finally included, and all surgeries were uneventful. The best corrected visual acuity (BCVA) (logMAR units) decreased from 1.29 ± 0.80 preoperatively to 0.97 ± 0.78 at the last follow‐up (p = 0.0012), improving in 28 patients (82.35%). The absolute value of mean defect (MD) significantly decreased (p |
| doi_str_mv | 10.1002/lary.30736 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2814528138</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2814528138</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3936-2f53fe62b41dc5f6b072ea7643a6ad49c47da2d2a0e7fd76f40a15cbec5b13243</originalsourceid><addsrcrecordid>eNp90c1O3DAUBWCroioDdNMHQJbYVEih_ontZIlmGEAadaRCpXYVOY49GDlxsBONsusj8Ix9EgxDWbDoxl7cz0dXPgB8wegMI0S-ORmmM4oE5R_ADDOKs7ws2R6YpSHNCkZ-7YODGO8RwoIy9AnsU4FLjAo0A9uV7zZ__zwOOrRwPQ7KtzrCpXfOb223gRdd46PyvVXwNsgudjJKB2_GsNFhgsYHuO6HNPyux-B7OdxNcDFqOHg4T9x6I5VND5a2Dn6McDHF3slo5RH4aKSL-vPrfQh-Li9u51fZan15PT9fZYqWlGfEMGo0J3WOG8UMr5EgWgqeU8llk5cqF40kDZFIC9MIbnIkMVO1VqzGlOT0EHzd5fbBP4w6DlVro9LOyU6nhSpS4JylgxaJnryj934MXdouKcoKxKngSZ3ulAo-xqBN1QfbpgYqjKrnOqrnOqqXOhI-fo0c61Y3b_Tf_yeAd2BrnZ7-E1Wtzn_83oU-AYE4l-k</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2835806376</pqid></control><display><type>article</type><title>Long‐term Outcomes Following Endoscopic Transnasal Surgery for Optic Neuropathy Due to Craniofacial Fibrous Dysplasia</title><source>Wiley Online Library All Journals</source><creator>Wang, Min ; Zhu, Senmiao ; Shen, Bingyan ; Fang, Yenan ; Xie, Qiqi ; Dai, Qin ; Chen, Ziwen ; Li, Xinyu ; Wu, Wencan</creator><creatorcontrib>Wang, Min ; Zhu, Senmiao ; Shen, Bingyan ; Fang, Yenan ; Xie, Qiqi ; Dai, Qin ; Chen, Ziwen ; Li, Xinyu ; Wu, Wencan</creatorcontrib><description>Objective
To investigate the feasibility of endoscopic transnasal optic canal decompression (ETOCD) guided by a navigation surgical system (NSS) for vision recovery in patients with compressive optic neuropathy (CON) caused by craniofacial fibrous dysplasia (CFD), and to explore the underlying cause of visual impairment.
Methods
All patients underwent unilateral NSS‐guided ETOCD and were followed up periodically for at least six months. Paired sample t‐test and Pearson correlation analyses were used to compare continuous variables of the visual outcomes at the final review. A histopathological test of abnormal bone specimens was performed postoperatively.
Results
Thirty‐four patients were finally included, and all surgeries were uneventful. The best corrected visual acuity (BCVA) (logMAR units) decreased from 1.29 ± 0.80 preoperatively to 0.97 ± 0.78 at the last follow‐up (p = 0.0012), improving in 28 patients (82.35%). The absolute value of mean defect (MD) significantly decreased (p < 0.001). Color vision was impaired in 17 patients preoperatively and improved in 6 patients. BCVA at the last follow‐up was significantly correlated with preoperative BCVA, onset time, preoperative retinal nerve fibril layer thickness, and MD (all p < 0.05). Among 34 patients, 26 had a blunt bony process near the anterior foot of the optic chiasm. Of the total patients, 73.53% patients experienced bony fiber recurrence 6 months or earlier after surgery without visual loss.
Conclusion
NSS‐guided ETOCD appeared to be safe and effective for visual recovery in patients with CON due to CFD, and early surgical intervention was critical for long‐term recovery. Unbalanced compression of the optic canal by the blunt bony process may be a major cause of visual impairment.
Level of Evidence
4 Laryngoscope, 133:1857–1866, 2023
The study presents a large prospective observational study of endoscopic unilateral optic nerve decompression in fibrous dysplasia patients presenting with optic neuropathy. Follow‐up was at least 6 months. NSS‐guided ETOCD appeared to be safe and effective for visual recovery in patients with CON due to CFD, and early surgical intervention was critical for long‐term recovery. Unbalanced compression of the optic canal by the blunt bony process may be a major cause of visual impairment.</description><identifier>ISSN: 0023-852X</identifier><identifier>EISSN: 1531-4995</identifier><identifier>DOI: 10.1002/lary.30736</identifier><identifier>PMID: 37191080</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>compressive optic neuropathy ; craniofacial fibrous dysplasia ; Endoscopy ; ETOCD ; Laryngoscopy ; navigation ; Visual impairment</subject><ispartof>The Laryngoscope, 2023-08, Vol.133 (8), p.1857-1866</ispartof><rights>2023 The Authors. published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.</rights><rights>2023 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.</rights><rights>2023. This article is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3936-2f53fe62b41dc5f6b072ea7643a6ad49c47da2d2a0e7fd76f40a15cbec5b13243</citedby><cites>FETCH-LOGICAL-c3936-2f53fe62b41dc5f6b072ea7643a6ad49c47da2d2a0e7fd76f40a15cbec5b13243</cites><orcidid>0000-0001-5210-5793 ; 0000-0002-7644-5773 ; 0000-0001-8525-375X ; 0000-0001-8556-1197</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Flary.30736$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Flary.30736$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,1416,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37191080$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Min</creatorcontrib><creatorcontrib>Zhu, Senmiao</creatorcontrib><creatorcontrib>Shen, Bingyan</creatorcontrib><creatorcontrib>Fang, Yenan</creatorcontrib><creatorcontrib>Xie, Qiqi</creatorcontrib><creatorcontrib>Dai, Qin</creatorcontrib><creatorcontrib>Chen, Ziwen</creatorcontrib><creatorcontrib>Li, Xinyu</creatorcontrib><creatorcontrib>Wu, Wencan</creatorcontrib><title>Long‐term Outcomes Following Endoscopic Transnasal Surgery for Optic Neuropathy Due to Craniofacial Fibrous Dysplasia</title><title>The Laryngoscope</title><addtitle>Laryngoscope</addtitle><description>Objective
To investigate the feasibility of endoscopic transnasal optic canal decompression (ETOCD) guided by a navigation surgical system (NSS) for vision recovery in patients with compressive optic neuropathy (CON) caused by craniofacial fibrous dysplasia (CFD), and to explore the underlying cause of visual impairment.
Methods
All patients underwent unilateral NSS‐guided ETOCD and were followed up periodically for at least six months. Paired sample t‐test and Pearson correlation analyses were used to compare continuous variables of the visual outcomes at the final review. A histopathological test of abnormal bone specimens was performed postoperatively.
Results
Thirty‐four patients were finally included, and all surgeries were uneventful. The best corrected visual acuity (BCVA) (logMAR units) decreased from 1.29 ± 0.80 preoperatively to 0.97 ± 0.78 at the last follow‐up (p = 0.0012), improving in 28 patients (82.35%). The absolute value of mean defect (MD) significantly decreased (p < 0.001). Color vision was impaired in 17 patients preoperatively and improved in 6 patients. BCVA at the last follow‐up was significantly correlated with preoperative BCVA, onset time, preoperative retinal nerve fibril layer thickness, and MD (all p < 0.05). Among 34 patients, 26 had a blunt bony process near the anterior foot of the optic chiasm. Of the total patients, 73.53% patients experienced bony fiber recurrence 6 months or earlier after surgery without visual loss.
Conclusion
NSS‐guided ETOCD appeared to be safe and effective for visual recovery in patients with CON due to CFD, and early surgical intervention was critical for long‐term recovery. Unbalanced compression of the optic canal by the blunt bony process may be a major cause of visual impairment.
Level of Evidence
4 Laryngoscope, 133:1857–1866, 2023
The study presents a large prospective observational study of endoscopic unilateral optic nerve decompression in fibrous dysplasia patients presenting with optic neuropathy. Follow‐up was at least 6 months. NSS‐guided ETOCD appeared to be safe and effective for visual recovery in patients with CON due to CFD, and early surgical intervention was critical for long‐term recovery. Unbalanced compression of the optic canal by the blunt bony process may be a major cause of visual impairment.</description><subject>compressive optic neuropathy</subject><subject>craniofacial fibrous dysplasia</subject><subject>Endoscopy</subject><subject>ETOCD</subject><subject>Laryngoscopy</subject><subject>navigation</subject><subject>Visual impairment</subject><issn>0023-852X</issn><issn>1531-4995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><recordid>eNp90c1O3DAUBWCroioDdNMHQJbYVEih_ontZIlmGEAadaRCpXYVOY49GDlxsBONsusj8Ix9EgxDWbDoxl7cz0dXPgB8wegMI0S-ORmmM4oE5R_ADDOKs7ws2R6YpSHNCkZ-7YODGO8RwoIy9AnsU4FLjAo0A9uV7zZ__zwOOrRwPQ7KtzrCpXfOb223gRdd46PyvVXwNsgudjJKB2_GsNFhgsYHuO6HNPyux-B7OdxNcDFqOHg4T9x6I5VND5a2Dn6McDHF3slo5RH4aKSL-vPrfQh-Li9u51fZan15PT9fZYqWlGfEMGo0J3WOG8UMr5EgWgqeU8llk5cqF40kDZFIC9MIbnIkMVO1VqzGlOT0EHzd5fbBP4w6DlVro9LOyU6nhSpS4JylgxaJnryj934MXdouKcoKxKngSZ3ulAo-xqBN1QfbpgYqjKrnOqrnOqqXOhI-fo0c61Y3b_Tf_yeAd2BrnZ7-E1Wtzn_83oU-AYE4l-k</recordid><startdate>202308</startdate><enddate>202308</enddate><creator>Wang, Min</creator><creator>Zhu, Senmiao</creator><creator>Shen, Bingyan</creator><creator>Fang, Yenan</creator><creator>Xie, Qiqi</creator><creator>Dai, Qin</creator><creator>Chen, Ziwen</creator><creator>Li, Xinyu</creator><creator>Wu, Wencan</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>WIN</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5210-5793</orcidid><orcidid>https://orcid.org/0000-0002-7644-5773</orcidid><orcidid>https://orcid.org/0000-0001-8525-375X</orcidid><orcidid>https://orcid.org/0000-0001-8556-1197</orcidid></search><sort><creationdate>202308</creationdate><title>Long‐term Outcomes Following Endoscopic Transnasal Surgery for Optic Neuropathy Due to Craniofacial Fibrous Dysplasia</title><author>Wang, Min ; Zhu, Senmiao ; Shen, Bingyan ; Fang, Yenan ; Xie, Qiqi ; Dai, Qin ; Chen, Ziwen ; Li, Xinyu ; Wu, Wencan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3936-2f53fe62b41dc5f6b072ea7643a6ad49c47da2d2a0e7fd76f40a15cbec5b13243</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>compressive optic neuropathy</topic><topic>craniofacial fibrous dysplasia</topic><topic>Endoscopy</topic><topic>ETOCD</topic><topic>Laryngoscopy</topic><topic>navigation</topic><topic>Visual impairment</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Min</creatorcontrib><creatorcontrib>Zhu, Senmiao</creatorcontrib><creatorcontrib>Shen, Bingyan</creatorcontrib><creatorcontrib>Fang, Yenan</creatorcontrib><creatorcontrib>Xie, Qiqi</creatorcontrib><creatorcontrib>Dai, Qin</creatorcontrib><creatorcontrib>Chen, Ziwen</creatorcontrib><creatorcontrib>Li, Xinyu</creatorcontrib><creatorcontrib>Wu, Wencan</creatorcontrib><collection>Wiley-Blackwell Open Access Titles</collection><collection>Wiley Free Content</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The Laryngoscope</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Min</au><au>Zhu, Senmiao</au><au>Shen, Bingyan</au><au>Fang, Yenan</au><au>Xie, Qiqi</au><au>Dai, Qin</au><au>Chen, Ziwen</au><au>Li, Xinyu</au><au>Wu, Wencan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long‐term Outcomes Following Endoscopic Transnasal Surgery for Optic Neuropathy Due to Craniofacial Fibrous Dysplasia</atitle><jtitle>The Laryngoscope</jtitle><addtitle>Laryngoscope</addtitle><date>2023-08</date><risdate>2023</risdate><volume>133</volume><issue>8</issue><spage>1857</spage><epage>1866</epage><pages>1857-1866</pages><issn>0023-852X</issn><eissn>1531-4995</eissn><abstract>Objective
To investigate the feasibility of endoscopic transnasal optic canal decompression (ETOCD) guided by a navigation surgical system (NSS) for vision recovery in patients with compressive optic neuropathy (CON) caused by craniofacial fibrous dysplasia (CFD), and to explore the underlying cause of visual impairment.
Methods
All patients underwent unilateral NSS‐guided ETOCD and were followed up periodically for at least six months. Paired sample t‐test and Pearson correlation analyses were used to compare continuous variables of the visual outcomes at the final review. A histopathological test of abnormal bone specimens was performed postoperatively.
Results
Thirty‐four patients were finally included, and all surgeries were uneventful. The best corrected visual acuity (BCVA) (logMAR units) decreased from 1.29 ± 0.80 preoperatively to 0.97 ± 0.78 at the last follow‐up (p = 0.0012), improving in 28 patients (82.35%). The absolute value of mean defect (MD) significantly decreased (p < 0.001). Color vision was impaired in 17 patients preoperatively and improved in 6 patients. BCVA at the last follow‐up was significantly correlated with preoperative BCVA, onset time, preoperative retinal nerve fibril layer thickness, and MD (all p < 0.05). Among 34 patients, 26 had a blunt bony process near the anterior foot of the optic chiasm. Of the total patients, 73.53% patients experienced bony fiber recurrence 6 months or earlier after surgery without visual loss.
Conclusion
NSS‐guided ETOCD appeared to be safe and effective for visual recovery in patients with CON due to CFD, and early surgical intervention was critical for long‐term recovery. Unbalanced compression of the optic canal by the blunt bony process may be a major cause of visual impairment.
Level of Evidence
4 Laryngoscope, 133:1857–1866, 2023
The study presents a large prospective observational study of endoscopic unilateral optic nerve decompression in fibrous dysplasia patients presenting with optic neuropathy. Follow‐up was at least 6 months. NSS‐guided ETOCD appeared to be safe and effective for visual recovery in patients with CON due to CFD, and early surgical intervention was critical for long‐term recovery. Unbalanced compression of the optic canal by the blunt bony process may be a major cause of visual impairment.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>37191080</pmid><doi>10.1002/lary.30736</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-5210-5793</orcidid><orcidid>https://orcid.org/0000-0002-7644-5773</orcidid><orcidid>https://orcid.org/0000-0001-8525-375X</orcidid><orcidid>https://orcid.org/0000-0001-8556-1197</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Wiley Online Library All Journals |
| subjects | compressive optic neuropathy craniofacial fibrous dysplasia Endoscopy ETOCD Laryngoscopy navigation Visual impairment |
| title | Long‐term Outcomes Following Endoscopic Transnasal Surgery for Optic Neuropathy Due to Craniofacial Fibrous Dysplasia |
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