Kountakis S E, Maillard A A, El-Harazi S M, Longhini L, Urso R G
Department of Otolaryngology-Head and Neck Surgery, University of Virginia Medical School, Charlottesville, VA 22906-0008, USA.
Otolaryngol Head Neck Surg. 2000 Jul;123(1 Pt 1):34-7. doi: 10.1067/mhn.2000.106007.
The goal of this study was to compare the outcome of patients with traumatic optic neuropathy (TON) treated with high-dose steroids with the outcome of patients with TON treated with endoscopic optic nerve decompression (EOND) after failing high-dose steroid treatment.
During this retrospective review of patients with TON seen from 1994 to 1998, all patients were first treated with megadose methylprednisolone for 48 hours. Patients with no improvement or with worsening visual acuity were offered EOND.
Eleven of 34 (32%) patients treated with high-dose steroids showed improvement, and 23 (68%) did not. Seventeen of the 23 patients without improvement after high-dose steroid treatment underwent EOND. Fourteen of 17 (82%) surgically treated patients had improved visual acuity, and 3 (18%) did not, with an overall improvement in 25 of 34 (74%) patients (chi(2) = 11. 338, P = 0.0007).
EOND is an appropriate treatment technique for patients with TON in whom high-dose steroid treatment has failed.
本研究的目的是比较高剂量类固醇治疗外伤性视神经病变（TON）患者的结果与高剂量类固醇治疗失败后接受内镜下视神经减压术（EOND）的TON患者的结果。
在对1994年至1998年期间诊治的TON患者进行的这项回顾性研究中，所有患者均首先接受大剂量甲基强的松龙治疗48小时。视力无改善或视力恶化的患者接受EOND治疗。
34例接受高剂量类固醇治疗的患者中有11例（32%）视力改善，23例（68%）未改善。23例高剂量类固醇治疗后无改善的患者中有17例接受了EOND治疗。17例接受手术治疗的患者中有14例（82%）视力改善，3例（18%）未改善，34例患者中有25例（74%）总体视力得到改善（χ² = 11. 338，P = 0.0007）。
对于高剂量类固醇治疗失败的TON患者，EOND是一种合适的治疗技术。
