颈部解剖术后前部缺血性视神经病变
Anterior ischemic optic neuropathy following neck dissection.
作者信息
Strome S E, Hill J S, Burnstine M A, Beck J, Chepeha D B, Esclamado R M
机构信息
Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical Center, Ann Arbor 48109, USA.
出版信息
Head Neck. 1997 Mar;19(2):148-52. doi: 10.1002/(sici)1097-0347(199703)19:2<148::aid-hed11>3.0.co;2-9.
BACKGROUND
Ischemic optic neuropathy (ION) is a rare but devastating complication of surgery. It has traditionally been associated with intraoperative hypotension in patients with underlying arteriosclerosis.
METHODS
We present a case of ION following bilateral neck dissections in which there was minimal intraoperative hypotension and preservation of both internal jugular veins. The potential etiology of this disease is discussed along with a review of the literature.
RESULTS
Five cases of ION following neck dissection have been documented. This complication is associated with the combination of intraoperative hypotension and anemia in the setting of prolonged bilateral neck dissection. Treatment is supportive, and final visual prognosis is variable.
CONCLUSIONS
Ischemic optic neuropathy following neck dissection is best avoided by intraoperative blood pressure and anemia management. When it does occur, supportive therapy must be given. Final visual outcome is variable.
背景
缺血性视神经病变（ION）是一种罕见但具有毁灭性的手术并发症。传统上，它与患有潜在动脉硬化的患者术中低血压有关。
方法
我们报告一例双侧颈部清扫术后发生ION的病例，术中低血压轻微且双侧颈内静脉均得以保留。本文将讨论该疾病的潜在病因，并对相关文献进行综述。
结果
已有5例颈部清扫术后发生ION的病例记录。这种并发症与双侧长时间颈部清扫术中低血压和贫血同时出现有关。治疗以支持治疗为主，最终视力预后各不相同。
结论
通过术中血压和贫血管理可最好地避免颈部清扫术后缺血性视神经病变的发生。一旦发生，必须给予支持治疗。最终视力结果各不相同。
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