Li K K, Lucarelli M J, Bilyk J R, Joseph M P
Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, USA.
Arch Otolaryngol Head Neck Surg. 1997 Apr;123(4):425-9. doi: 10.1001/archotol.1997.01900040061010.
To evaluate the outcome of extracranial optic nerve decompression in patients with compressive optic neuropathy secondary to intracranial, paranasal sinus, or orbital neoplastic processes.
A retrospective chart review and clinical follow-up of patients who underwent optic nerve decompression.
Tertiary care referral center.
During an 8-year period, 95 extracranial optic nerve decompressions were performed by one of us (M.P.J.) for optic neuropathy resulting from traumatic, inflammatory, infectious, iatrogenic, neoplastic, and idiopathic processes. Thirty patients with compressive optic neuropathy secondary to histopathologically confirmed tumors were identified.
Optic nerve decompression via external ethmoidectomy approach.
Twenty (67%) of 30 patients showed improvement in vision. Improvement in 17 of the 20 patients has been stable. Seven patients (23%) showed no improvement but there was no further worsening of vision after surgery. In 3 patients (10%) vision deteriorated following surgery.
Extracranial optic nerve decompression may be considered for the preservation or improvement of vision in selected patients with compressive optic neuropathy from neoplasms.
评估因颅内、鼻窦或眼眶肿瘤性病变继发的压迫性视神经病变患者行颅外视神经减压术的效果。
对接受视神经减压术的患者进行回顾性病历审查和临床随访。
三级医疗转诊中心。
在8年期间，我们中的一人（M.P.J.）对因创伤、炎症、感染、医源性、肿瘤性和特发性病变导致的视神经病变进行了95次颅外视神经减压术。确定了30例经组织病理学证实为肿瘤继发的压迫性视神经病变患者。
通过外部筛窦切除术进行视神经减压。
30例患者中有20例（67%）视力改善。20例患者中有17例的视力改善情况稳定。7例患者（23%）无改善，但术后视力未进一步恶化。3例患者（10%）术后视力恶化。
对于部分因肿瘤导致压迫性视神经病变的患者，可考虑行颅外视神经减压术以保留或改善视力。
