A Rare Case of Optic Nerve Sheath Meningioma in a Pediatric Patient: Diagnosis and Endoscopic Endonasal Surgical Management

We describe an unusual instance of a juvenile with proptosis and progressive one sided vision loss. Radiological imaging showed an intraorbital lesion indicative of optic nerve sheath meningioma (ONSM). An endoscopic endonasal surgical method was used for tumor excision, given the medial orbital position of the lesion and growing vision loss. Optimal exposure and decompression were obtained using careful dissection and intraoperative navigation. The patient had visual improvement in follow-up evaluations; the postoperative period was quiet. This instance underlines the value of endoscopic endonasal surgery in some individuals and contributes to the limited research on pediatric ONSM. Endoscopic techniques provide better access to the medial orbit with the least morbidity as compared to conventional treatments. Although surgery could be better in young patients with quickly advancing symptoms or in situations with secondary lesions, radiation is still the norm for adult ONSMs. Even in physically difficult environments, our study corroborates the results from previous literature suggesting the viability and safety of this strategy in pediatric populations. Particularly when visual function is at stake, endoscopic endonasal surgery is a feasible and efficient therapy choice for children with ONSM. Favorable results depend on early diagnosis and tailored surgical planning.