Optic Nerve Atrophy Due to Long-Standing Compression by Planum Sphenoidale Meningioma

Highlights

• We report a rare endoscopic endonasal image of an atrophic optic nerve as seen after surgical removal of a suprasellar meningioma.

• The complete optic nerve atrophy was due to long-lasting local compression applied by the tumor.

• The advantages of the endonasal approaches can be recognized, mainly lack of brain retraction and favorable dissection of the tumor from surrounding tissues.

Purpose

In this study we report an uncommon endoscopic endonasal image of an atrophic optic nerve as seen after surgical removal of a suprasellar meningioma. The peculiarity of this case is the long-lasting underestimated ocular symptomatology of the patient who reported a 15-year history of impairment of vision on her left eye.

Methods

A 51-year-old woman was admitted to our hospital complaining of a 15-year history of impairment of vision on her left eye. After making serendipitously the diagnosis of a suprasellar mass, we performed endoscopic endonasal surgery.

Results

The tumor was reached from below and removed safely, without manipulation of the optic pathways. At the end of tumor removal, the impressive left optic nerve atrophy due to enduring local tumor compression was visualized.

Conclusions

To the best of our knowledge, no endoscopic endonasal image with such features has been provided in the pertinent literature. Possibly, this contribution will help identify damaged optic nerves during endoscopic endonasal surgery.