Optic Nerve Decompression with Release of the Meningo-Orbital Band in Medial Sphenoid Wing Meningiomas Improves and Preserves Visual Acuity

Document Type



General Surgery (East Africa)


Objectives: Medial sphenoid wing meningiomas often present with reduced vision from compression of the optic nerve. We postulated that optic nerve decompression with bony decompression and release of the meningo-orbital band can result in stable or improved vision.

Methods: Retrospective review of medial meningiomas with optic nerve compression operated in a single unit from 2006 to 2015. Visual acuity was compared pre and post-op.

Results: We identified 18 patients. All had craniotomies.15/18 (83.3%) patients presented with reduced vision. 5 had only light perception in the affected eye. 12/18 (66.7%) of the patients had decompression of the optic nerve including release of the meningo-orbital band. One patient experienced worsening acuity due to hydrocephalus. A third of patients 6/18 (33%) had improvement of their vision with 5/18 (27.8%) having undergone optic nerve decompression. Excluding those who presented with only light perception, this increases to 5/13 (38.5%). 6/12 of those decompressed had stable vision (2 had normal vision preoperatively). Patients who presented with only light perception had no improvement in vision.

Conclusion: In patients with optic nerve compression from medial meningiomas, optic nerve decompression with the release of the meningo-orbital band is useful in preservation of vision. In those decompressed 5/12(41.6%) had improvement and a further 6/12(50%) had stable vision. Optic nerve decompression should be considered before or at early stages of visual loss, as no improvement was demonstrated in those with minimal vision preoperatively.

Publication (Name of Journal)

Journal of Neurological Surgery Part B: Skull Base

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.