Optic nerve glioma surgery: Difference between revisions

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{{CMG}}
{{CMG}}{{AE}}{{Simrat}}
{{Optic nerve glioma}}
{{Optic nerve glioma}}
==Overview==
==Overview==
Treatment varies with the size of the tumor and the general health of the person. The goal may be to cure the disorder, relieve symptoms, or improve vision and comfort.
[[Surgery]] is not the first-line treatment option for patients with optic nerve glioma. Surgical excision is usually reserved for patients with either progressive [[proptosis]], [[blindness]], exophytic chiasm [[tumor]] causing mass effect, [[hydrocephalus]], or with increased [[intracranial pressure]].
==Surgery==
==Surgery==
Surgical removal may cure some optic gliomas. Partial removal to reduce the bulk of the tumor can be done in many cases. This will keep the tumor from damaging normal brain tissue around the tumor.
*Usually surgery is not preferred for this type of tumor, but it can sometimes improve vision and/or relieve symptoms.
===Radiation therapy===
*If the glioma causes an increase in [[intracranial pressure]], [[excision]] may be required.
Radiation therapy may be advised in some cases where the tumor is larger and surgery is not possible. In some cases, radiation therapy may be delayed because of the slow growth that this tumor typically displays.
*Surgery is not recommended among patients with residual vision.
*Surgical treatment for optic pathway gliomas usually involves either excision or [[biopsy]] of the [[tumor]].  
*Surgery is the first choice when single nerve involvement is causing either progressive disfiguring [[proptosis]], [[blindness]], or an exophytic chiasm tumor is causing mass effect or [[hydrocephalus]].<ref name="pmid7674005">{{cite journal| author=Sutton LN, Molloy PT, Sernyak H, Goldwein J, Phillips PL, Rorke LB et al.| title=Long-term outcome of hypothalamic/chiasmatic astrocytomas in children treated with conservative surgery. | journal=J Neurosurg | year= 1995 | volume= 83 | issue= 4 | pages= 583-9 | pmid=7674005 | doi=10.3171/jns.1995.83.4.0583 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7674005  }} </ref>
*Diffuse infiltration of the chiasm is a contraindication to surgery.
*Due to damage the risk of visual loss as well as damage to surrounding neurologic structures, surgical intervention for gliomas involving the optic chiasm is considered only for obtaining a biopsy specimen of the chiasm in certain cases or for relieving hydrocephalus.
*[[NF-1]] patients have increased risk of local recurrence after surgery than non-NF patients and tend to have less localized disease.


==References==
==References==
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[[Category:Neurology]]
[[Category:Neurology]]
[[Category:Ophthalmology]]
[[Category:Ophthalmology]]
[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Ophthalmology]]
[[Category:Neurosurgery]]

Latest revision as of 14:48, 27 November 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

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Overview

Surgery is not the first-line treatment option for patients with optic nerve glioma. Surgical excision is usually reserved for patients with either progressive proptosis, blindness, exophytic chiasm tumor causing mass effect, hydrocephalus, or with increased intracranial pressure.

Surgery

  • Usually surgery is not preferred for this type of tumor, but it can sometimes improve vision and/or relieve symptoms.
  • If the glioma causes an increase in intracranial pressure, excision may be required.
  • Surgery is not recommended among patients with residual vision.
  • Surgical treatment for optic pathway gliomas usually involves either excision or biopsy of the tumor.
  • Surgery is the first choice when single nerve involvement is causing either progressive disfiguring proptosis, blindness, or an exophytic chiasm tumor is causing mass effect or hydrocephalus.[1]
  • Diffuse infiltration of the chiasm is a contraindication to surgery.
  • Due to damage the risk of visual loss as well as damage to surrounding neurologic structures, surgical intervention for gliomas involving the optic chiasm is considered only for obtaining a biopsy specimen of the chiasm in certain cases or for relieving hydrocephalus.
  • NF-1 patients have increased risk of local recurrence after surgery than non-NF patients and tend to have less localized disease.

References

  1. Sutton LN, Molloy PT, Sernyak H, Goldwein J, Phillips PL, Rorke LB; et al. (1995). "Long-term outcome of hypothalamic/chiasmatic astrocytomas in children treated with conservative surgery". J Neurosurg. 83 (4): 583–9. doi:10.3171/jns.1995.83.4.0583. PMID 7674005.

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