鼻内镜下视神经减压治疗外伤性视神经病

目的 探讨鼻内镜下视神经减压治疗外伤性视神经病的疗效。方法 对外伤性视神经病患者应用大剂量皮质类固醇治疗，无效者15例行鼻内镜下视神经减压术。术前视力无光感者5例，光感者4例，眼前手动者3例，眼前数指者2例，视力0.1者1例。受伤至术前不足7d 4例，超过7d 11例。结果 术后随访3个月至4年， 9例视力有不同程度提高，总有效率为60%，术前无光感眼有效率为20%，有光感以上视力者术后有效率为80%。结论 鼻内镜视神经减压对外伤性视神经管内段神经病疗效确切、较其他径路创伤较小，尽管超过创伤7d，仍然是一种良好方法。

Transnasal endoscopic optic nerve decompression in traumatic optic neuropathy

Objective To review the effect of optic nerve decompression by the endoscopic technique in traumatic optic neuropathy. Methods Fifteen patients (15 eyes) with traumatic optic neuropathy who were treated with large dose of glucocorticoid in 2 days but were inefficacious were undergone endoscopic optic nerve decompression. The days from injury to surgery were 3 to 32 days. Among them, 4 cases were in 4 to7days and 11 cases were >7days. 10 eyes were with light perception or higher grades pre-operation and 5 eyes were with no light perception. Results All patients were followed up for 1more than 3 months. Nine of 15 eyes had improvements in visual acuity with the total effect rate 60%. One of 5 eyes with no light perception had raises in visual acuity (20%). Eight of 10 eyes with light perception or higher grades had improvements (80%). Conclusion Endoscopic optic nerve decompression is an appropriate technique for patients with traumatic optic neuropathy.