Endoscopic Endonasal Approach to the Optic Nerve: A Technical Note

An endoscopic endonasal technique was used in the surgical treatment of a meningioma compressing the optic nerve. The patient was a 58-year-old woman who had experienced progressive visual loss in her left eye. Magnetic resonance (MR) scans of the brain demonstrated a contrast-enhancing tumor mass, which was measured to be 10 x 15 mm in size, compressing the left optic nerve. Automated visual field examination confirmed left-eye visual field defects, the temporal visual field worse than the nasal. The tumor was excised in total endoscopically through her right nostril. Histological diagnosis was meningothelial meningioma. Her hospital stay was overnight. Her left-eye vision improved with a residual crescentic temporal-field defect. She has done well without tumor recurrence as evidenced by a 20-month follow-up. This is the first report describing endoscopic endonasal removal of an intracranial tumor compressing the optic nerve.