Villain M A, Candon E, Arnaud B, Hamard H, Adenis J-P
Service d'Ophtalmologie, Hôpital Gui de Chauliac, 80, avenue Augustin Fliche, CHU Montpellier, 34295 Montpellier Cedex 5.
J Fr Ophtalmol. 2003 Feb;26(2):191-7.
Optic nerve sheath decompression is a surgical procedure only used in optic neuropathy complicating idiopathic intracranial hypertension. We describe this technique and compare it with the classic technique of cerebrospinal liquid derivation. Several points contrast optic nerve sheath decompression and cerebrospinal fluid derivation: there is no biomaterial, it is limited to the orbital area, and intracranial pressure remains unchanged. The complications are different, yet analysis of the literature shows the same efficacy in terms of visual function. We recommend a practical management of optic neuropathy complicating idiopathic intracranial hypertension, depending on the functional severity and the therapeutic efficacy. The surgical indication should only concern serious optic neuropathy not responding to medical therapy, with the choice of the surgical technique belonging to the surgeon.
视神经鞘减压术是一种仅用于特发性颅内高压并发视神经病变的外科手术。我们描述了该技术，并将其与经典的脑脊液引流技术进行比较。视神经鞘减压术与脑脊液引流术在几个方面存在差异：不使用生物材料，局限于眼眶区域，颅内压保持不变。并发症不同，但文献分析表明在视觉功能方面疗效相同。我们建议根据功能严重程度和治疗效果，对视神经病变并发特发性颅内高压进行切实可行的管理。手术指征应仅涉及对药物治疗无反应的严重视神经病变，手术技术的选择由外科医生决定。
