He Zhen-Hua, Lan Zheng-Bo, Xiong Ao, Hou Guo-Kuo, Pan Ya-Wen, Li Qiang, Zhang Xin-Ding
Institute of Neurology, Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou 730030, China.
Chin J Traumatol. 2016 Dec 1;19(6):330-332. doi: 10.1016/j.cjtee.2016.03.004.
Traumatic optic neuropathy (TON) is a serious complication of head trauma with the incidence rate of 0.5%-5%. The aim of this study was to investigate the therapeutic efficacy of endoscopic decompression of the optic canal for optic nerve injuries.
In this study, 11 patients treated in our hospital from January 2009 to January 2015 with the visual loss resulting from TON were retrospectively reviewed for preoperative vision, visual evoked potential (VEP) scan, surgical approach, postoperative visual acuity, complications, and follow-up results.
All these patients received endoscopic decompression of the optic canal. At the 3-month follow- up, the visual acuity improvement rate of the 11 patients was 45.5%. The vision acuity of 2 cases improved from hand movement to 0.08 and 0.3 after operation. Another patient's vision acuity returned to 0.05 compared to light sensation preoperatively. Two cases had finger counting before surgery but they had a vision acuity of 0.4 and light sensation respectively after surgery. However, the other 6 cases' vision did not improve after surgery.
Endoscopic decompression of the optic canal is an effective way to cure TON. VEP could be used as an important reference for preoperative and prognosis evaluation. Operative time after trauma is only a relative condition that may affect the therapeutic effect of optic canal decompression. Poor results of this procedure may be related to the severity of the optic nerve injury.
创伤性视神经病变（TON）是头部外伤的一种严重并发症，发病率为0.5%-5%。本研究的目的是探讨视神经管内镜减压术治疗视神经损伤的疗效。
回顾性分析2009年1月至2015年1月在我院治疗的11例因TON导致视力丧失患者的术前视力、视觉诱发电位（VEP）扫描、手术方式、术后视力、并发症及随访结果。
所有患者均接受了视神经管内镜减压术。在3个月的随访中，11例患者的视力改善率为45.5%。2例患者术后视力从手动改善至0.08和0.3。另1例患者术前仅有光感，术后视力恢复至0.05。2例患者术前只能数指，术后视力分别为0.4和光感。然而，另外6例患者术后视力未改善。
视神经管内镜减压术是治疗TON的有效方法。VEP可作为术前及预后评估的重要参考。外伤后的手术时间只是可能影响视神经管减压治疗效果的一个相关因素。该手术效果不佳可能与视神经损伤的严重程度有关。
