Endoscopic Transnasal Removal of Cavernous Hemangiomas of the Optic Canal.

PURPOSE: To assess the feasibility and efficacy of endoscopic transnasal removal of cavernous hemangiomas of the optic canal.

DESIGN

Retrospective, noncomparative case series.

METHODS

Eleven consecutive patients (11 eyes) with cavernous hemangioma of the optic canal underwent endoscopic trans-ethmoidal-sphenoidal removal of the tumor at the Eye Hospital of Wenzhou Medical University from January 2009 to March 2016. In each case, the indication for surgery was decreased visual acuity due to the tumor. The removal was believed to be complete if the tumor was removed en bloc during the surgery. A mucoperiosteal flap was used to cover the defect in the optic nerve sheath after tumor removal. The tumor was pathologically confirmed to be cavernous hemangioma after surgery. The mean follow-up time was 9.9 ± 5.5 months. Visual acuity before and after surgery was compared.

RESULTS

All tumors were completely removed by the endoscopic approach. The best-corrected visual acuity (BCVA) improved after surgery in all patients. The mean preoperative BCVA was 6/30 (95% confidence interval [CI] 6/60-6/20) and the mean postoperative BCVA was 6/10 (95% CI 6/12-6/7.5). All patients showed cerebrospinal fluid rhinorrhea, which resolved with strict bed rest. Other complications included hyposmia in 2 patients; nasal bleeding in 3 patients, which resolved spontaneously; and temporary headache.

CONCLUSIONS

Endoscopic trans-ethmoidal-sphenoidal approach is a feasible option for cavernous hemangiomas of the optic canal.