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Endoscopic transnasal anterior clinoidectomy for optic canal unroofing in a patient with fibrous dysplasia of the sphenoid bone
J Korean Skull Base Soc 2021;16(2):114-119
Published online September 30, 2021
© 2021 Korean Skull Base Society.

Juan Luis Gómez-Amador, Marcos Vinicius Sangrador-Deitos, Luis Alberto Rodriguez Hernandez, Aldo Gabriel Eguiluz Meléndez

Department of Neurosurgery, National Institute of Neurology and Neurosurgery “Manuel Velasco Suarez”, Mexico City, Mexico
Correspondence to: Marcos Vinicius Sangrador-Deitos
주소 : Department of Neurosurgery, National Institute of Neurology and Neurosurgery “Manuel Velasco Suarez”, Insurgentes Sur 3877, La Fama, Tlalpan, 14269 Mexico City, Mexico
Tel : +52-4621412652
Fax : +52-5556063822
E-mail : marcos_5949@hotmail.com
Received August 20, 2021; Accepted September 10, 2021.
Abstract
Fibrous dysplasia (FD) is a rare, benign disease, characterized by the replacement of normal medullary bone by fibro-osseous tissue. It is caused by somatic mutations in the α subunits of the stimulatory G protein encoded by the GNAS gene. FD can be divided into three categories. FD must be considered with any clival, sellar or parasellar lesion, especially with bone affection. Visual disturbances are one of the most disabling complications of this disease, secondary to optic canal compression. There is still controversy whether unroofing of the optic canal should be performed in these cases. We present the case of a 30-year-old woman who presented to our institution with a 3 weeks history of headache and blurred vision, for which a neuronavigated transnasal endoscopic resection was planned. We present a novel surgical approach, in which we performed a conventional transellar approach, with complete resection of an osseous lesion which infiltrated the sella turcica and clivus. Unroofing of the left optic canal and complete decompression of the optic nerve were performed, as well as an extradural clinoidectomy.
Keywords : Anterior clinoid, Clivus, Monostotic fibrous dysplasia, Neuroendoscopy


September 2021, 16 (2)
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