Ohmae T, Ashikawa R, Ichikawa T
Rhinology. 1986 Sep;24(3):211-7.
The cause of disturbed visual acuity associated with intranasal ethmosphenoidectomy is, on the one hand, a direct injury to the optic nerve. In this case, the disturbance in visual acuity develops immediately after the operation, and severe visual complications with a poor prognosis are found. On the other hand, in the two cases presented in this paper, the disturbed visual acuity develops postoperatively. In this case, it is necessary to take various possibilities into consideration, such as indirect effects of intraorbital bleeding, and damage to the lamina papyracea due to indirect and direct injury. Moreover, effects on the peri-optic nerve area and small blood vessels within the osseous optic canal should be considered. After thorough consideration and observation of the response to conservative therapy, such complications should be treated by investigating whether or not decompression of the optic nerve is effective.
鼻内筛蝶窦切除术相关的视力障碍原因，一方面是视神经直接损伤。在这种情况下，术后视力障碍立即出现，且会发现严重的视力并发症，预后较差。另一方面，在本文所呈现的两例病例中，视力障碍是术后出现的。在这种情况下，有必要考虑多种可能性，如眶内出血的间接影响、间接和直接损伤导致的纸样板损伤。此外，还应考虑对视神经周围区域及骨性视神经管内小血管的影响。在充分考虑并观察保守治疗的反应后，对于此类并发症应通过研究视神经减压是否有效来进行治疗。
