经鼻内镜眶尖和视神经管减压术治疗创伤性视神经病

Management of traumatic optic neuropathy with endoscopic orbital apex and optic canal decompression

目的探讨经鼻内镜眶尖和视神经管减压术治疗创伤性视神经病的疗效和影响因素。方法对该科2004年10月～2005年11月41例(42眼)经鼻内镜眶尖和视神经管减压术患者的临床资料进行回顾性分析。结果42眼中,21眼视力获得提高,有效率50.00%。伤后有残余视力和无眶尖骨折者疗效优于伤后无光感和有眶尖骨折者(P<0.05)。伤后7d内接受手术和无视神经管骨折者术后视力提高百分比较7d后手术者和有视神经管骨折者高,但无统计学意义(P>0.05)。结论经鼻内镜眶尖和视神经管减压术是治疗创伤性视神经病的有效手术方式。

[Objective] To study the effect of traumatic optic neuropathy treated with orbital apex and optic canal decompression through transnasal endoscope. [Methods] The data of 41cases of traumatic optic neuropathy treated with orbital apex and optic canal decompression by transnasal endoscope from October 2004 to November 2005 were retrospectively reviewed. [Results] Among 42 eyes, the final visual acuity improved in 21 （50.00%）. The patients with residual vision and cases without orbital apex fracture had better improvement in visual acuity than those without residual vision immediately after trauma and those with fracture （P 〈0.05）. The percentages of visual improvement in cases without optic canal fracture and the course of disease before operation in 7 days were higher than that with fracture and over 7 days. But there was no statistic difference between two groups （P 〉0.05）. [Conclusion] Orbital apex and optic canal decompression through transnasal endoscope is beneficial in the management of traumatic optic neuropathy.