Nishimura Kunihiro, Takahashi Yasuhiro, Katahira Nobuyuki, Uchida Yasue, Ueda Hiromi, Ogawa Tetsuya
Departments of Otorhinolaryngology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
Department of Oculoplastic, Orbital, and Lacrimal Surgery, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
Auris Nasus Larynx. 2019 Dec;46(6):876-881. doi: 10.1016/j.anl.2019.03.010. Epub 2019 Apr 9.
To compare postoperative changes in visual acuity between the transnasal endoscopic approach and the transcaruncular approach when comparison of preoperative values used for medial orbital wall decompression in patients with dysthyroid optic neuropathy.
We included 14 patients (23 sides) and divided them into a transnasal group (11 sides, 8 patients) and a transcaruncular group (12 sides, 6 patients). Visual acuity was examined preoperatively, on postoperative days 1, 3, and 7, and at a final follow-up visit. The differences in postoperative improvement of the logarithm of the minimum angle of resolution (logMAR) visual acuity and critical flicker frequency (CFF) between the two surgical groups at each time point were analyzed using the Mann-Whitney U test.
Postoperative improvement in logMAR visual acuity on postoperative days 1 and 3 and that in CFF on postoperative day 1 were greater in the endonasal group than in the transcaruncular group (P < 0.050). Vision was improved or maintained in all patients in the transnasal group at the final follow-up. One patient in the transcaruncular group had loss of vision on one side and decreased vision on the other side after surgery.
Medial orbital decompression appears to provide better postoperative vision when performed by the transnasal approach than by the transcaruncular approach in patients with dysthyroid optic neuropathy.
比较甲状腺相关性视神经病变患者眼眶内侧壁减压术前用于比较经鼻内镜入路和经泪阜入路术后视力的变化。
我们纳入了14例患者（23侧），将其分为经鼻组（11侧，8例患者）和经泪阜组（12侧，6例患者）。术前、术后第1天、第3天和第7天以及末次随访时检查视力。使用Mann-Whitney U检验分析两个手术组在每个时间点的最小分辨角对数（logMAR）视力和临界闪烁频率（CFF）术后改善情况的差异。
经鼻组术后第1天和第3天的logMAR视力改善以及术后第1天的CFF改善均大于经泪阜组（P < 0.050）。经鼻组所有患者在末次随访时视力得到改善或维持。经泪阜组1例患者术后一侧视力丧失，另一侧视力下降。
对于甲状腺相关性视神经病变患者，经鼻入路进行眼眶内侧壁减压术后视力似乎比经泪阜入路更好。
