[Clinical analysis of traumatic optic nerve dysfunction].
OBJECTIVE
To evaluate the key factors in diagnosis, treatment and prognosis of optic nerve trauma at the canalicular segment.


METHODS
Twenty-six patients with optic nerve dysfunction resulted from trauma to the nerve at canalicular segment were analyzed. All the patients received orbital CT scans, corticosteroid therapy and surgical optic canal decompression through the external ethmoid approach.


RESULTS
With the help of CT scan, the total diagnostic rate was 66.7%; that for canal fracture was 81.3%, for nerve swelling 56.3%. The improvement rate of surgical decompression depended on the time of visual loss and types of toauma. Specifically, the improvement rate was 57.1% in patients with visual loss occurred immediately after the trauma, 83.3% in patients with visual loss occurred a moment after the trauma, 66.7% in patients with optic nerve swelling and 56.3% with optic canal fracture. The possibility of recovery decreased with delay of the surgery.


CONCLUSIONS
Orbital CT scan facilitates the diagnosis of optic canal fracture. However, the possibility of traumatic optic nerve dysfunction can not be ruled out in patients without the sign of canal fracture in the CT scan. The key factors in determining nerve recovery were associated with the severity of optic nerve trauma and the chance of surgery. Serious trauma and delay of the surgery may result in the blindness.
Zhang
T
T
Department of Otorhinolaryngology, First Affiliated Hospital of Medical College, Jinan University, Guangzhou 510630.
Wang
J
J
Yang
Z
Z
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D002648:Child; D003131:Combined Modality Therapy; D019299:Decompression, Surgical / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009901:Optic Nerve Diseases / Q000503:physiopathology* / Q000628:therapy; D020221:Optic Nerve Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones