Intraosseous lipoma of the sphenoid bone causing optic nerve compression: A case report

Figure 1 Visual field perimetry (octopus 101) demonstrating the preoperative and postoperative status. A: Left eye (Oculus Sinister) preoperatively, exhibiting significant visual field loss, particularly affecting the inferotemporal region; B: Left eye (Oculus Sinister) postoperatively, revealing marked improvement and substantial recovery of visual fields after surgical decompression.

Figure 2 T1-weighted magnetic resonance imaging scan showing a hyperintense fat-containing lesion within the left anterior clinoid process/sphenoid bone at the optic canal, causing extrinsic compression of the left optic nerve, consistent with an intraosseous lipoma.

Figure 3 Key surgical steps in extradural anterior clinoidectomy and optic nerve decompression. A: Extradural drilling of the anterior clinoid process using a diamond high-speed drill; B: Opening the optic canal with 1-mm Kerrison punch; C: Demonstration of extradural clinoidectomy and decompression of the optic canal; D: Opening the optic nerve dural sleeve; E: Use of a mini hook to verify complete optic nerve decompression intradural; F: Completely decompressed and free optic nerve, with adipose tissues (indicated by blue arrow) cleared away.

Figure 4 Postoperative axial T1-weighted magnetic resonance imaging demonstrating successful decompression of the left optic nerve canal and clearance of previously seen fat-containing lesion.