鼻内镜视神经管减压术治疗外伤性视神经病

Transnasal endoscopic approach to optic canal decompression in traumatic optic neuropthy

目的：探讨鼻内镜视神经管减压术治疗外伤性视神经病的临床疗效。方法：分别对12例外伤性视神经病患者使用激素和鼻内镜视神经管减压术进行治疗。结果：随访3～19个月。激素治疗的2例中1例视力恢复至0．6，1例一度出现光感又失明；手术治疗的10例中3例视力不同程度改善，7例无效。全部病例无并发症，术腔上皮化良好，没有面部手术疤痕。结论：鼻内镜视神经管减压术是治疗外伤性视神经病较好的方法。

Objective： To search the features of traumatic optic neuropathy and effective method of transnasal endoscopic optic canal decomrpession in traumatic optic neuropathy. Methods： Twelve patients with traumatic optic neuropathy were given corticosteroids or underwent transnasal endoscopic optic canal decompression. Results： All patients were followed up for 3-19 months. Vision in one of two patients treated with corticosteroids recovered from blind to 0.6, but another improved to blindsight, then soon degenerated into blind once again. In ten cases accepted transnasal endoscopic optic canal decomrpession, three cases had improved visual acuity but seven cases did not. The operative sinus got well and no complication had happened. Conclusion： Transnasal endoscopic sphenoethmoidal optic canal decompression is a better method for traumatic optic neuropathy. When vision acuity of these patients was given by treatment of steroids had not made progress, transnasal endoscopic approach to optic canal decompression should be performed as soon as possible so as not to miss out of recoverable visual acuity.