[Indication and prognosis of the transethmoidal decompression of the optical nerve in posttraumatic amaurosis (author's transl)].

In 8 patients with unilateral posttraumatic amaurosis a transethmoidal decompression of the optical nerve was performed. In 4 patients the vision returned completely after operation, 1 patient showed only a partial improvement and in 3 cases the amaurosis remained unchanged. These results agree with those reported by Japanese authors (Sugita et al., 1965; Fukado, 1968) and suggest, that opposite to the neurosurgical transfrontal-intradural resection of the roof of the optical canal the rhinosurgical transethmoidal decompression of the optical nerve may improve the prognosis of the posttraumatic amaurosis, espcially, if the decompression can be done as soon after trauma as possible. Further advantages of this surgical method are the smaller risk, the shorter operation time and the preservation of olfaction. It is emphasized that the rhinologist cannot indicate the decompression of the optical nerve without consulting the ophthalmologist and the neurologist. Contraindications are lesions of the bulbus oculi and the fundus, lesions of the chiasma opticum and a posttraumatic amaurosis caused by a sinus-cavernosus-fistula. Regarding the experiences gained by rhinosurgeons so far the early transethmoidal decompression seems to be indicated, if a unilateral impairment of vision exists right after the trauma or develops within the next 24-48 hrs and if there is no damage to the bulbus and the fundus.