RESUMEN
A 48-year-old woman noted progressive, painless visual loss in her left eye. She was diagnosed with bilateral optic nerve sheath meningiomas (ONSMs), extending across the planum sphenoidale. Radiation was offered, but the patient declined. She has been followed for more than 27 years with stable visual function and neuroimaging findings. Bilateral ONSMs, although usually described as aggressive in nature, may follow a stable clinical course.
Asunto(s)
Meningioma/patología , Neoplasias del Nervio Óptico/patología , Trastornos de la Visión/patología , Anciano , Progresión de la Enfermedad , Femenino , Humanos , Meningioma/complicaciones , Meningioma/fisiopatología , Persona de Mediana Edad , Neoplasias del Nervio Óptico/complicaciones , Neoplasias del Nervio Óptico/fisiopatología , Negativa del Paciente al Tratamiento , Trastornos de la Visión/etiología , Trastornos de la Visión/fisiopatología , Agudeza Visual/fisiologíaRESUMEN
Incisions used for orbital floor exploration continues to remain a topic of controversy. Historically, 3 incisions have been used for orbital floor repair: transconjunctival, subciliary, and subtarsal. Past studies have attempted to stratify the superiority of one incision over the others. Insufficient level of evidence and inconsistent methodology have lead to inconclusive data. Our authors performed a systematic review of literature to assess the quality of evidence in literature and recommend guidelines for incisions for repairing orbital fractures. Thirty-one articles were identified, comprising a total of 4688 incisions. Technique along with individual benefits and complication profiles for each incision is reviewed. Objectivity and follow-up time intervals are necessary parameters for evaluating incisions for orbital floor exploration to further define guidelines.