The Experts below are selected from a list of 312 Experts worldwide ranked by ideXlab platform
Bradley K. Farris - One of the best experts on this subject based on the ideXlab platform.
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Farris-Tang retractor in optic Nerve Sheath decompression surgery.
Orbit (Amsterdam Netherlands), 2015Co-Authors: Jennifer A. Spiegel, Jason A. Sokol, Thomas J. Whittaker, Benjamin J. Bernard, Bradley K. FarrisAbstract:ABSTRACTPurpose: Our purpose is to introduce the use of the Farris–Tang retractor in optic Nerve Sheath decompression surgery.Methods: The procedure of optic Nerve Sheath fenestration was reviewed at our tertiary care teaching hospital, including the use of the Farris–Tang retractor.Results: Pseudotumor cerebri is a syndrome of increased intracranial pressure without a clear cause. Surgical treatment can be effective in cases in which medical therapy has failed and disc swelling with visual field loss progresses. Optic Nerve Sheath decompression surgery (ONDS) involves cutting slits or windows in the optic Nerve Sheath to allow cerebrospinal fluid to escape, reducing the pressure around the optic Nerve. We introduce the Farris-Tang retractor, a retractor that allows for excellent visualization of the optic Nerve Sheath during this surgery, facilitating the fenestration of the Sheath and visualization of the subsequent cerebrospinal fluid egress. Utilizing a medial conjunctival approach, the Farris–Tang re...
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pseudotumor cerebri and optic Nerve Sheath decompression
Ophthalmology, 2000Co-Authors: James T Banta, Bradley K. FarrisAbstract:Abstract Objective To determine the efficacy and safety of optic Nerve Sheath decompression in a large population of patients with pseudotumor cerebri with visual loss despite medical treatment and to suggest a treatment algorithm on the basis of these data. Design Retrospective, noncomparative, interventional case series. Participants One hundred fifty-eight eyes in 86 patients with pseudotumor cerebri. Intervention Optic Nerve Sheath decompression. Main outcome measures Visual acuity, visual fields, and surgical complications. Results After optic Nerve Sheath decompression for pseudotumor cerebri, visual acuity stabilized or improved in 148 of 158 (94%) eyes, and visual fields stabilized or improved in 71 of 81 (88%) eyes. Surgical complications, most of which were transient and benign, were seen in 39 of 86 patients. Only one eye in one patient had permanent severe visual loss secondary to an operative complication. Conclusions In patients with pseudotumor cerebri with progressive visual loss despite maximum medical therapy, optic Nerve Sheath decompression is a safe and effective means of stabilizing visual acuity and the visual fields of those tested.
Thomas C. Spoor - One of the best experts on this subject based on the ideXlab platform.
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Histopathology and ultrastructural examination of optic Nerve Sheath biopsies after optic Nerve Sheath decompression with and without mitomycin.
Ophthalmic plastic and reconstructive surgery, 2001Co-Authors: Mehryar Taban, Thomas C. Spoor, John G. Mchenry, Alfredo A. SadunAbstract:Purpose We chose to compare histologically and ultrastructurally changes in the optic Nerve Sheath after optic Nerve Sheath decompression, initially after a second surgery and after treatment with mitomycin-C. The mechanism by which optic Nerve Sheath decompression alleviates papilledema can be further understood in consideration of the results. Methods Tissue was obtained by biopsy from 3 first-time surgical and 4 reoperative cases with and without mitomycin-C in patients with idiopathic intracranial hypertension. The Sheaths were fixed in a mixture of 2% paraformaldehyde and 2% glutaraldehyde, osmicated and dehydrated in a series of ethanol, and finally embedded in epon. Tissue blocks were sectioned at 1 microm and stained with both PPD and toluidine blue. Thin sections were examined by transmission electron microscopy. Results Normal meningeal tissue obtained at the time at optic Nerve Sheath decompression consisted mainly of collagen, closely packed and roughly parallel to the axis of the optic Nerve. Collagen deposition seen in scar tissue after secondary optic Nerve Sheath decompression was extremely disorganized and irregular, with the individual fibers laid down seemingly at random. There was little sense of layering or of parallel arrays. Mitomycin-C appeared to influence collagen deposition in such a way that the collagen was more regularly packed and more closely resembled unoperated tissue. Conclusions The regular well-organized collagen packing seen in normal Sheath tissue is disrupted and replaced by less organized but compact scar tissue after optic Nerve Sheath decompression. With mitomycin use, more regular collagen packing closely approximating that found in unoperated Sheath occurs. This configuration of fibers lends support for the filtration mechanism of optic Nerve Sheath decompression in treating papilledema.
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Optic Nerve Sheath Decompression With Adjunctive Mitomycin and Molteno Device Implantation
Archives of ophthalmology (Chicago Ill. : 1960), 1994Co-Authors: Thomas C. Spoor, John G. Mchenry, Dong H. ShinAbstract:Optic Nerve Sheath decompression is an effective treatment for pseudotumor cerebri and visual loss. Although this treatment is successful in reducing papilledema and improving visual function in 80% to 90% of patients, 30% of successful optic Nerve Sheath decompressions eventually fail. 1 There are several treatment options after a failed optic Nerve Sheath decompression: repeated optic Nerve Sheath decompression, acetazolamide sodium, lumboperitoneal shunting, serial lumbar punctures, and corticosteroids. Acetazolamide use is limited by patient intolerance, gastrointestinal-tract side effects, and paresthesia. Corticosteroids are only practical in the short term and can increase intracranial pressure when therapy is tapered. Lumboperitoneal shunts frequently fail and become infected, and visual loss may continue in spite of a functioning shunt. Repeated optic Nerve Sheath decompressions require meticulous dissection through extensive orbital scarring and are not as successful as primary decompressions. 1 Controversy exists as to the mechanism of action of optic Nerve Sheath decompression. We
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Treatment of pseudotumor cerebri by primary and secondary optic Nerve Sheath decompression.
American journal of ophthalmology, 1991Co-Authors: Thomas C. Spoor, John M. Ramocki, Matthew P. Madion, Michael J. WilkinsonAbstract:We performed optic Nerve Sheath decompression in 53 patients (101 eyes) with pseudotumor cerebri and visual loss. Sixty-nine eyes (85 patients) with acute papilledema uniformly had improved visual function after optic Nerve Sheath decompression. Of 32 eyes with chronic papilledema (18 patients), only ten had improved visual function after optic Nerve Sheath decompression. This difference was significant (P = .0001). Thirteen eyes required secondary or tertiary optic Nerve Sheath decompression after an initial successful result. Eleven of 13 eyes had improved visual function after repeat optic Nerve Sheath decompression. We believe that patients with acute papilledema and visual loss should be offered optic Nerve Sheath decompression, and if symptoms recur, repeat optic Nerve Sheath decompression is a safe and effective treatment option.
Pan Xuefei - One of the best experts on this subject based on the ideXlab platform.
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Visual improvement and pain resolution in traumatic optic Nerve Sheath meningocele treated by optic Nerve Sheath fenestration.
Restorative neurology and neuroscience, 2014Co-Authors: Chen Hui, Wu Xiaoyun, Chen Ningbo, Qiu Xizhong, Yang Shaowei, Lin Wei, Zhao Maozhu, Ma Wubo, Pan XuefeiAbstract:PURPOSE: There is no consensus as to the optimum treatment for traumatic optic neuropathy (TON). The decision to intervene medically or surgically, or simply observe was recommended to be on an individual basis. The purpose of this study is to test whether optic Nerve Sheath fenestration (ONSF) could improve vision in patients with traumatic optic Nerve Sheath meningocele, although it was reported to be effective in patients with traumatic optic Nerve Sheath hematoma. METHODS: ONSF was performed on two traumatic patients with dilated optic Nerve Sheath from MRI. RESULTS: Both patients initially suspected as traumatic optic Nerve Sheath hematoma were diagnosed as traumatic optic Nerve Sheath meningocele by intraoperative findings of the enlarged optic Nerve Sheath and clear fluid drained without evidence of blood in the subdural space. Moreover, significant orbit/head pain resolution and visual improvement within a week after ONSF was found. CONCLUSIONS: When TON presents with an enlarged optic Nerve/Sheath on CT or MRI with visual loss, an optic Nerve Sheath meningocele should be considered with the consideration that ONSF may benefit both visual acuity and post-traumatic pain, if present.
Michael J. Wilkinson - One of the best experts on this subject based on the ideXlab platform.
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Treatment of pseudotumor cerebri by primary and secondary optic Nerve Sheath decompression.
American journal of ophthalmology, 1991Co-Authors: Thomas C. Spoor, John M. Ramocki, Matthew P. Madion, Michael J. WilkinsonAbstract:We performed optic Nerve Sheath decompression in 53 patients (101 eyes) with pseudotumor cerebri and visual loss. Sixty-nine eyes (85 patients) with acute papilledema uniformly had improved visual function after optic Nerve Sheath decompression. Of 32 eyes with chronic papilledema (18 patients), only ten had improved visual function after optic Nerve Sheath decompression. This difference was significant (P = .0001). Thirteen eyes required secondary or tertiary optic Nerve Sheath decompression after an initial successful result. Eleven of 13 eyes had improved visual function after repeat optic Nerve Sheath decompression. We believe that patients with acute papilledema and visual loss should be offered optic Nerve Sheath decompression, and if symptoms recur, repeat optic Nerve Sheath decompression is a safe and effective treatment option.
Edward G. Buckley - One of the best experts on this subject based on the ideXlab platform.
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Pediatric optic Nerve Sheath decompression.
Ophthalmology, 2005Co-Authors: Daniel D. Thuente, Edward G. BuckleyAbstract:Purpose To review our experience with optic Nerve Sheath decompression for pediatric pseudotumor cerebri. Design Retrospective chart review. Participants Seventeen eyes in 12 children younger than 16 years of age. All patients were either unresponsive or intolerant to medication. Intervention, Methods, or Testing An optic Nerve Sheath fenestration was performed. Main Outcome Measures Optic Nerve appearance, visual acuity, color vision, and visual fields. Results The average age at surgery was 10.1 years of age. The average follow-up was 39.6 months. Headache was the most common presenting symptom. All patients showed improvement in optic Nerve edema. Visual acuity improved or stayed the same in all surgical eyes ( P = 0.0078). One patient required a neurosurgical lumbar peritoneal shunt, and 2 patients required acetazolamide on the last follow-up appointment. No patient had postoperative infection, loss of vision, or strabismus develop. Five of the patients in this study required Sheath decompression on the other eye. Conclusions Optic Nerve Sheath decompression in children is safe, and the results are similar to those obtained in adults. Close follow-up is required, because 5 of 12 patients in this study required a contralateral optic Nerve Sheath decompression.