How I do it: endoscopic endonasal chiasmopexy for optic chiasm prolapse.

BACKGROUND

Prolapse of the optic system into an empty sella is an unusual complication of the management of pituitary tumors.

METHOD: We described the technical nuances for an endoscopic endonasal chiasmopexy, the indications for the procedure, and the caveats on the diagnosis of optic chiasm prolapse.

CONCLUSION

The endoscopic endonasal chiasmopexy provides a direct route to lift the optic system. In most cases, the procedure may be achieved extradurally, protecting the chiasm from manipulation and postoperative fibrosis.