Optic nerve sheath fenestration: a revised lateral approach for nerve access

ABSTRACT

Idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri, describes a disease of poorly understood pathophysiology with a specific set of signs and symptoms including potentially irreversible and blinding visual loss. Optic nerve sheath fenestration (ONSF) is a well-described surgical treatment for patients with IIH and progressive visual loss despite maximally tolerated medical therapy. A number of optic nerve access procedures have been described including medial transconjunctival, superomedial lid crease, and lateral orbitotomy with and without bone takedown. The purpose of this report is to describe a revised lateral approach for temporal optic nerve access that obviates the need to traverse through the intraconal fat of the central surgical space in the previously described lateral approach techniques.

KEYWORDS:

• Idiopathic intracranial hypertension
• lateral orbitotomy
• optic nerve sheath fenestration
• pseudotumor cerebri

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Additional information

Funding

This work was supported in part by: NIH Center Core Grant P30EY014801; Research to Prevent Blindness Unrestricted Grant, Inc, New York, New York; and the Dr. Nasser Ibrahim Al-Rashid Orbital Vision Research Fund. The sponsor or funding organization had no role in the design or conduct of this research;National Eye Institute [P30EY014801];Research to Prevent Blindness [Unrestricted Grant];