[Optic chiasm XXXX (author's transl)].

@entity1 @entity162 @entity1640 @entity5 @entity979 @entity11 @entity5150 @entity2339 @entity3 @entity4786 @entity976 @entity4903
A follow up study of 40 cases of optic chiasm @entity11 is presented. Histological examination was obtained in 26 cases. All were @entity162 . Four of these were @entity5150 , 17 chiasmatic @entity11 and 19 invasive @entity5 . The main clinical features are reviewed with special @entity4903 , including precocious puberty and @entity1640 emaciation. @entity4786 was present in 30%. Diagnostic difficulties are outlined, especially in @entity5 without optic nerve involvement: event with C T scan, the differential diagnosis with @entity979 , @entity976 and primary @entity2339 , may be difficult. The operative mortality was 12% (3/25). All but one, had radiotherapy either alone or post operative. All four of the @entity1 with unilateral @entity5150 have a normal C T scan more than 10 years after treatment. Of the 17 @entity1 with chiasmatic @entity11 , 14 are alive with normal C T scan in 2 cases, and with reduction in size of the @entity5 in 7. Eleven of 19 @entity1 with @entity3 are alive with diminished size of the @entity5 in 7. Improvement in visual acuity, reduction in size of @entity5 mass, persistent increase in size of non irradiated @entity5 and lack of recurrence of @entity5150 even with histological proven chiasmatic involvement is taken as evidence of the effect of radiotherapy. The sub frontal approach is emphasized for optic nerve and optic chiasm @entity5 : it provides direct surgical verification with the opportunity for complete removal, large biopsy, decompression of the optic foramina or cyst removal. @entity4903 , radiotherapy is discussed in @entity1 . If necessary it must be managed under careful evaluation of endocrine status, principally growth function.
