外伤性视神经病变的治疗进展

Progress in treatment of traumatic optic neuropathy

外伤性视神经病变(TON)是颅颌面部外伤后严重视力丧失的重要原因,主要发生区域是视神经管及其前后端。TON的治疗方式目前主要有单纯观察、糖皮质激素治疗和视神经管减压手术,但关于治疗方式、治疗时机、手术入路的确定,目前尚无统一标准。但是无论是否使用糖皮质激素,视神经管减压术,特别是内镜经鼻-筛蝶视神经管减压术可使TON患者的视力显著提高。尽早手术和初始视力是影响手术治疗效果的重要因素。本文围绕TON的治疗进展进行综述。

Traumatic optic neuropathy(TON)is a significant cause of severe visual loss after craniofacial trauma.The optic canal and its anterior and posterior ends are the main areas of TON.At present,the treatment of TON mainly includes simple observation,glucocorticoid therapy,and optic canal decompression surgery.However,there is currently no unified standard on how to choose the treatment method,grasp the timing of treatment,and which surgical approach to use.Research suggests that regardless of the use of glucocorticoids,optic canal decompression surgery,especially endoscopic transnasal transsphenoidal optical canal decompression,can significantly improve the visual acuity of TON patients.Early surgery and initial vision are important factors that affect the effectiveness of surgical treatment.This article reviews the treatment progress of TON.