Abstract
We report a rare case of right optic nerve prolapse after endoscopic transsphenoidal surgery for a non functional pituitary macroadenoma. We believe this is the first reported case of isolated optic nerve prolapse without chiasma involvement with empty sella in the English literature. This 31-year-old male initially presented with progressively worsening right blurring of vision without hormonal disturbance. Post operatively, vision improved tremendously and continued to improve over 6 months of follow up. Nasoendoscopic examination than revealed a pulsating mass occupying the sphenoid sinus cavity. MRI of paranasal sinuses and base of skull showed a right optic nerve prolapsing into the empty sella. The patient was managed conservatively over more than 6 months and eventually the vision improved to the pre-operative state without requiring surgical intervention.

Ruth Ng, Farah Dayana Zahedi, Salina Husain, Syazarina Sharis Osman, Jegan Thanabalan, Ramesh Kumar, Balwant Singh Gendeh. (2017) Prolapse optic nerve in empty sella with delayed visual deterioration post-endoscopic pituitary surgery: A rare case, , Volume-42, Issue-1.
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