Chen Y R, Breidahl A, Chang C N
Division of Neurosurgery, Chang Gung Medical College, Taipei, Taiwan.
Plast Reconstr Surg. 1997 Jan;99(1):22-30; discussion 31-3. doi: 10.1097/00006534-199701000-00004.
Optic nerve decompression is controversial in posttraumatic visual loss and as a prophylactic therapy in fibrous dysplasia involving the optic canal. It is less controversial for the treatment of optic nerve compression in fibrous dysplasia. Thirteen patients with craniomaxillofacial fibrous dysplasia who underwent 16 optic nerve decompressions at the Chang Gung Craniofacial Centre for both therapeutic (10) and prophylactic (6) indications are reported. One patient sustained a clinically useful improvement in vision in response to two therapeutic decompressions, and another demonstrated marked improvement after therapeutic decompression, with visual acuity improving from 0.4 to 1.0 in the affected eye. No patient underwent a permanent deterioration of vision as a result of either therapeutic or prophylactic decompression. One patient suffered extraocular muscle dysfunction that was corrected with strabismus surgery. A review of the literature clarifies the controversies and allows establishment of indications for optic nerve decompression.
视神经减压术在创伤后视力丧失以及作为涉及视神经管的骨纤维异常增殖症的预防性治疗方面存在争议。而在治疗骨纤维异常增殖症导致的视神经受压方面争议较小。本文报道了13例颅颌面骨纤维异常增殖症患者，在长庚颅面中心接受了16次视神经减压术，其中治疗性指征10例，预防性指征6例。1例患者在接受两次治疗性减压术后视力得到临床意义上的改善，另1例患者在治疗性减压术后视力显著改善，患眼视力从0.4提高到1.0。没有患者因治疗性或预防性减压导致视力永久性恶化。1例患者出现眼外肌功能障碍，通过斜视手术得以纠正。文献回顾澄清了相关争议，并确定了视神经减压术的指征。
