Surgical Consideration to Optic Nerve Protrusion According to Sinus Computed Tomography

Abstract

OBJECTIVES: This study aimed to investigate the prevalence of optic nerve protrusion (ONP) and its clinical indicators by using sinus computed tomography (CT) scan.

STUDY DESIGN: Sinus CT scans of 260 consecutive patients with chronic inflammatory sinus disease were reviewed.

RESULTS: The prevalence of ONP in our study population was 28%. Nineteen percent of the optic nerves protruded into the sphenoid sinuses including indentation of the sinus wall (12%) and coursing through the sphenoid sinus (8%). In the presence of contralateral ONP and/or ipsilateral anterior clinoid process pneumatization, the chance of ONP occurrence was significantly higher (both P < 0.01). They were reliable indicators of ONP (R 2 = 0.47, P < 0.01).

CONCLUSIONS: ONP is a common anatomic variation observed in patients with chronic inflammatory sinus disease. To reduce optic nerve damage in surgeries, the presence of ONP according to sinus CT scans and the intraoperative findings should be carefully evaluated.

EBM rating: C-4

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