Rajiniganth M G, Gupta Ashok K, Gupta Amod, Bapuraj Jayapalli Rajiv
Department of Otorhinolaryngology and Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Arch Otolaryngol Head Neck Surg. 2003 Nov;129(11):1203-6. doi: 10.1001/archotol.129.11.1203.
To assess the visual outcome in cases of traumatic optic neuropathy treated with a combined therapy protocol of methylprednisolone injections and endoscopic optic nerve decompression.
Prospective, nonrandomized study.
Academic tertiary care referral center.
The study included 44 patients with posttraumatic indirect optic nerve injury.
Visual acuity.
Visual improvement was achieved in 31 patients (70%) when treatment was initiated within 7 days of injury, whereas only 10 patients (24%) showed improvement when the treatment was started after more than 7 days. The time lapse after injury and treatment, degree of visual loss, and computed tomographic evidence of canalicular and pericanalicular fractures were found to be significant prognostic factors.
Endoscopic optic nerve decompression is a minimally invasive procedure that does not cause any adverse cosmetic effects. The risk-benefit ratio suggests that the combined therapy protocol of methylprednisolone injections and endoscopic optic nerve decompression results in a better visual outcome, without any major risks.
评估采用甲基泼尼松龙注射联合内镜下视神经减压的联合治疗方案治疗创伤性视神经病变的视觉效果。
前瞻性、非随机研究。
学术性三级医疗转诊中心。
该研究纳入了44例创伤性间接视神经损伤患者。
视力。
受伤后7天内开始治疗的31例患者（70%）视力得到改善，而受伤7天以上开始治疗的患者中只有10例（24%）视力有所改善。发现受伤与治疗之间的时间间隔、视力丧失程度以及眶神经管和眶神经管周围骨折的计算机断层扫描证据是重要的预后因素。
内镜下视神经减压是一种微创手术，不会造成任何不良美容效果。风险效益比表明，甲基泼尼松龙注射联合内镜下视神经减压的联合治疗方案能带来更好的视觉效果，且无任何重大风险。
