[Transnasal optic nerve decompression for optic nerve injury].
OBJECTIVE
To investigate the feasibility, techniques and advantages of the treatment of optic nerve injury by intranasal endoscopic surgery.


METHODS
This retrospective study presents the results of 39 cases (40 optic nerves) of indirect optic neuropathy where surgical decompression represented the primary mode of treatment within 2-18 days after trauma. The surgery is performed using the transethmoidal or trans-sphenoid technique. The optic nerve canal and fracture line are located in Onodi cells or lateral wall of sphenoid sinus. The optic nerve and its sheath are exposed, and the nose is packed by gelfoam; The medication and Hyperbaric oxygen are used after surgical.


RESULTS
The following up period is at least 3 months. The total effective rate of visual improvement was 60%, and the effective rate operating within 2-7 days or 8-18 days after trauma turned out to be 66.7% and 30%.


CONCLUSIONS
The endoscopic technique offers several advantages over other surgical approaches. It provides excellent visualization of the surgical site, avoids the morbidity associated with intracranial and external exeracranial approaches and offers the best option for recovery of useful vision. With the development of this technique, the indication should be extended. The prognosis had correlated with the degree of trauma, days until surgery and surgical technique.
Zhang
Hongping
H
Department of Otorhinolaryngology, the Second Hospital of Shandong University, Jinan, 250033, China. tydzhp@sohu.com
Zhang
Daliang
D
Chen
Xuemei
X
D000293:Adolescent; D000328:Adult; D002648:Child; D019299:Decompression, Surgical / Q000379:methods*; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020221:Optic Nerve Injuries / Q000601:surgery*; D012189:Retrospective Studies