Kim Jin Young, Kim Hyun Jun, Kim Chang-Hoon, Lee Jeung-Gweon, Yoon Joo-Heon
Department of Otorhinolaryngology, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, Korea.
Yonsei Med J. 2005 Apr 30;46(2):300-4. doi: 10.3349/ymj.2005.46.2.300.
Major orbital complications after the endoscopic sinus surgeries are rare and of these, optic nerve injury is one of the most serious. This study was to undertaken to analyze 3 cases of optic nerve injury after endoscopic sinus surgery. The three cases included one patient with a loss of visual acuity and visual field defect, and two patients with total blindness. In all cases, no improvement of visual acuity was observed despite treatment. It is important to frequently check the location and direction of the endoscope during surgery to avoid optic nerve injury. In addition, surgeons must have a precise knowledge of the detailed anatomy through cadaver dissections, an ability to interpret the PNS CT scan and experienced procedural surgical skills.
鼻窦内窥镜手术后的严重眼眶并发症较为罕见,其中视神经损伤是最严重的并发症之一。本研究旨在分析3例鼻窦内窥镜手术后视神经损伤的病例。这3例病例包括1例视力丧失和视野缺损患者,以及2例完全失明患者。所有病例经治疗后视力均未改善。手术过程中频繁检查内窥镜的位置和方向以避免视神经损伤很重要。此外,外科医生必须通过尸体解剖精确了解详细解剖结构,具备解读鼻窦计算机断层扫描(PNS CT)的能力以及丰富的手术操作经验。