{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T10:43:00Z","timestamp":1779273780266,"version":"3.51.4"},"reference-count":22,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,3,24]],"date-time":"2022-03-24T00:00:00Z","timestamp":1648080000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Optic pathway gliomas in children carry significant morbidity and therapeutic challenges. For the subgroup of pre-chiasmatic gliomas, intraorbital and intradural resection is a curative option after blindness. We present a two-center cohort using different surgical approaches. A retrospective analysis was performed, including 10 children. Mean age at surgery was 6.8 years. Interval between diagnosis and surgery was 1\u201374 (mean 24 \u00b1 5.5, median 10) months. Indications for surgery were exophthalmos, pain, tumor progression, or a combination. Eight patients underwent an extradural trans-orbital-roof approach to resect the intra-orbital tumor, including the optic canal part plus intradural pre-chiasmatic resection. Gross total resection was achieved in 7\/8, and none had a recurrence. One residual behind the bulbus showed progression, treated by chemotherapy. In two patients, a combined supra-orbital mini-craniotomy plus orbital frame osteotomy was used for intraorbital tumor resection + intradural pre-chiasmatic dissection. In these two patients, remnants of the optic nerve within the optic canal remained stable. No patient had a chiasmatic functional affection nor permanent oculomotor deficits. In selected patients, a surgical resection from bulb to chiasm \u00b1 removal of optic canal tumor was safe without long-term sequela and with an excellent cosmetic result. Surgery normalizes exophthalmos and provides an effective tumor control.<\/jats:p>","DOI":"10.3390\/children9040459","type":"journal-article","created":{"date-parts":[[2022,3,25]],"date-time":"2022-03-25T00:05:18Z","timestamp":1648166718000},"page":"459","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Surgical Management of Pre-Chiasmatic Intraorbital Optic Nerve Gliomas in Children after Loss of Visual Function\u2014Resection from Bulbus to Chiasm"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4725-713X","authenticated-orcid":false,"given":"Julian","family":"Zipfel","sequence":"first","affiliation":[{"name":"Section of Pediatric Neurosurgery, Department of Neurosurgery, University Hospital of Tuebingen, 72076 Tuebingen, Germany"},{"name":"Centre of Neurofibromatosis, Centre of Rare Diseases, University Hospital of Tuebingen, 72076 Tuebingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonas","family":"Tellermann","sequence":"additional","affiliation":[{"name":"Section of Pediatric Neurosurgery, Department of Neurosurgery, University Hospital of Tuebingen, 72076 Tuebingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorothea","family":"Besch","sequence":"additional","affiliation":[{"name":"Section of Periocular and Orbital Surgery, Department of Ophthalmology, University Hospital Tuebingen, 72076 Tuebingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eckart","family":"Bertelmann","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Charit\u00e9-Medical University, 13353 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4229-8058","authenticated-orcid":false,"given":"Martin","family":"Ebinger","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology, University Children\u2019s Hospital of Tuebingen, 72076 Tuebingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo Hern\u00e1iz","family":"Driever","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology\/Hematology and Stem Cell Transplantation, Charit\u00e9-Medical University, 13353 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9168-6209","authenticated-orcid":false,"given":"Jens","family":"Schittenhelm","sequence":"additional","affiliation":[{"name":"Institute of Pathology and Neuropathology, University Hospital of Tuebingen, 72076 Tuebingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rudi","family":"Beschorner","sequence":"additional","affiliation":[{"name":"Institute of Pathology and Neuropathology, University Hospital of Tuebingen, 72076 Tuebingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arend","family":"Koch","sequence":"additional","affiliation":[{"name":"Institute of Neuropathology, Charit\u00e9-Medical University, 13353 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrich-Wilhelm","family":"Thomale","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Division of Pediatric Neurosurgery, Charit\u00e9-Medical University, 13353 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin Ulrich","family":"Schuhmann","sequence":"additional","affiliation":[{"name":"Section of Pediatric Neurosurgery, Department of Neurosurgery, University Hospital of Tuebingen, 72076 Tuebingen, Germany"},{"name":"Centre of Neurofibromatosis, Centre of Rare Diseases, University Hospital of Tuebingen, 72076 Tuebingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1007\/s00381-006-0086-7","article-title":"Optic pathway glioma: Outcome and prognostic factors in a surgical series","volume":"22","author":"Ahn","year":"2006","journal-title":"Child\u2019s Nerv. 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