鼻内镜下视神经管减压术治疗外伤性视神经病变

Transnasal endoscopic optic canal decompression in traumatic optic neuropathy.

目的探讨鼻内镜下视神经管减压术对外伤性视神经病变的疗效及预后相关因素。方法分析10例(10眼)鼻内镜下视神经管减压术治疗外伤性视神经病变的临床特征及治疗效果。10例术前CT资料显示眶部无明显骨折者4例,眶前部骨折5例,眶后部骨折仅1例;术前无光感者7例,有部分视力者3例。结果术后随访6个月,7例无光感者术后视力无改善者5例,3例有部分视力者术后视力有不同程度提高;4例眶部无明显骨折者2例视力有不同程度改善,5例眶前部骨折者3例不同程度改善,而1例眶后部骨折者术后视力无改善。无手术并发症。结论外伤性视神经病变预后因素可能包括眶部有无骨折、视力受损程度、接受治疗的措施及时间等;鼻内镜下视神经管减压术是目前治疗外伤性视神经病变的一种微创、有效的手段之一。

Objective To evaluate the significance of transnasal endoscopic optic canal decompression in traumatic optic neuropathy（TON） and prognosis factors.Mehods The clinic data of 10 patients with traumatic optic neuropathy under intrasnasal endoscopic optic canal decompression were analyzed.Among the 10 patients with TON,there were 4 patients without orbital fractures,5 patients with anterior orbital fractures,1 patient with posterior orbital fractures.7 patients had no light perception and 3 patients had some degree of visual acuity.Results Followingup six months,the sight of 2 patients among 4 patients without orbital fractures improved with some degree,the sight of 3 patients among 5 patients with anterior orbital fractures partially improved,the sight of one patient with posterior orbital fractures had no improvement.The sight of those 5 patients with no light perception had no improvement,3 patients with some degree of visual acuity improved.No complication had occurred after surgery.Conclusions The prognos is factors maybe include orbital fractures,and the damaged degree of visual acuity,the time and measures of treatment. Transnasal endoscopic optic canal decompression is an effective and minitraumatic methods at present.