Sieśkiewicz Andrzej, Łysoń Tomasz, Rogowski Marek, Mariak Zenon
Klinika Otolaryngologii AM w Białymstoku.
Otolaryngol Pol. 2008;62(3):295-9. doi: 10.1016/S0030-6657(08)70258-0.
Optic nerve decompression is nowadays increasingly performed using endoscopic technique. THE AIM of this report is to present a clinical series of 8 patients operated on with this technique due to posttraumatic loss of vision and other visual disturbances. Technical details of this procedure and surgical anatomy will also be discussed.
Endoscopic optic nerve decompression was performed in eight patients using transnasal transethmoidal approach. The loss of vision was caused by posttraumatic optic neuropathy in 6 patients, optic neuritis in 1 patient and by cystic lesion of the orbital apex and sphenoid sinus in 1 patient.
Vision acuity improvement was achieved in 4 patients (50%). Complications included intraoperative cerebrospinal fluid leak occurred in 2 patients. In one of them the leak had to be sealed using intracranial approach.
Endoscopic optic nerve decompression can be used in appropriately selected patients with optic nerve lesions to improve the visual functions. High technical skill, proper endowment and thorough knowledge of surgical anatomy are prerequisites of success. Good interdisciplinary cooperation between the laryngologist and neurosurgeon helps in minimizing the risk of serious complications, especially in posttraumatic cases.
如今，视神经减压术越来越多地采用内镜技术进行。本报告的目的是展示一组8例因创伤后视力丧失及其他视觉障碍而接受该技术手术的临床病例。还将讨论该手术的技术细节及手术解剖结构。
8例患者采用经鼻经筛窦入路进行内镜下视神经减压术。6例患者视力丧失由创伤后视神经病变引起，1例由视神经炎引起，1例由眶尖及蝶窦囊性病变引起。
4例患者（50%）视力得到改善。并发症包括2例患者术中发生脑脊液漏。其中1例漏液必须采用颅内入路进行封闭。
内镜下视神经减压术可用于适当选择的视神经病变患者，以改善视觉功能。高超的技术、合适的设备及对手术解剖结构的透彻了解是成功的前提条件。耳鼻喉科医生与神经外科医生之间良好的跨学科合作有助于将严重并发症的风险降至最低，尤其是在创伤后病例中。
