Maier W, Laubert A, Weinel P
Department of Oto-Rhino-Laryngology, Universität Freiburg, Germany.
J Laryngol Otol. 1994 Oct;108(10):873-7. doi: 10.1017/s0022215100128373.
Sudden unilateral visual loss in children is usually caused by a complication of acute purulent sinusitis. Differential diagnosis must include malignant tumours of the orbit or the paranasal sinuses involving the optic nerve. Rapid and adequate diagnostic measures are required in this emergency situation. In comparison, acute or progressive bilateral blindness is a very rare disorder. We report two cases of bilateral visual loss caused by malignant tumours and diagnostic and therapeutic strategies are described. Our reports show that these life-threatening disorders and their severe complications can be managed successfully if well-coordinated interdisciplinary cooperation is conducted from the beginning. If surgery is performed in this vulnerable region, it may be facilitated by computer-aided modelling techniques. During the last decade the prognosis for rhabdomyosarcoma and malignant lymphoma, the most frequent mesenchymal tumours of childhood, has improved dramatically. Thus, any loss of time causing a delay in correct diagnosis and the onset of adequate therapy must be avoided. Intensive cooperation with paediatric oncologists has to be enlisted from the beginning to avoid unnecessary, repetitive, invasive, or imaging diagnostics and to accelerate the onset of specific therapy.
儿童突发单侧视力丧失通常由急性化脓性鼻窦炎的并发症引起。鉴别诊断必须包括累及视神经的眼眶或鼻窦恶性肿瘤。在这种紧急情况下需要迅速而充分的诊断措施。相比之下，急性或进行性双侧失明是一种非常罕见的病症。我们报告了两例由恶性肿瘤导致的双侧视力丧失病例，并描述了诊断和治疗策略。我们的报告表明，如果从一开始就进行协调良好的多学科合作，这些危及生命的病症及其严重并发症是可以成功处理的。如果在这个易损区域进行手术，计算机辅助建模技术可能会有所帮助。在过去十年中，横纹肌肉瘤和恶性淋巴瘤这两种儿童最常见的间叶性肿瘤的预后有了显著改善。因此，必须避免任何导致正确诊断延迟和适当治疗开始延误的时间损失。从一开始就必须争取与儿科肿瘤学家密切合作，以避免不必要的、重复的、侵入性的或影像学诊断，并加快特定治疗的开始。
