We have located links that may give you full text access.
English Abstract
Journal Article
[Microsurgical endonasal decompression in traumatic and neoplastic optic nerve compression].
UNLABELLED: The therapy of traumatic optic neuropathy remains controversial. Some authors recommend observation and others, the use of megadose corticosteroids or surgical decompression of the optic nerve. Improvements in visual acuity from no light perception (NLP) preoperatively to close to normal visual acuities have been reported after transethmoidal decompression and systemic steroids. The transnasal microscopic approach offers safe and effective access to the optic canal.
MATERIALS AND METHODS: Retrospectively 15 patients (13 men/2 women) ranging in age from 17 to 67 years, who were surgically decompressed in the Ear-Nose-Throat Department between 1989 and 1994, were analyzed. Thirteen patients had experienced sudden visual loss after trauma; in 2 patients a tumor was diagnosed. After an initial ophthalmologic examination and CT scans, the patients underwent transnasal decompression of the optic canal for at least 180 degrees. In the postoperative period, visual acuity, pupillary reaction, visual field and optic nerve morphology were monitored.
RESULTS: The overall visual results were poor. In 8 patients with no light perception (NLP) preoperatively, no improvement in visual acuity was found. Minor improvements were seen with an initial vision of 20/200 or less. Dramatic improvements were found in both patients with rapidly progressive neoplastic optic nerve compression. No intra- or postoperative complications were seen.
CONCLUSION: In our study we were unable to reproduce the good visual results of some series. If there is NLP preoperatively, surgical intervention does not seem to be promising. However, in patients with incurable tumors transnasal decompression of the optic canal offers a minimally invasive palliative measure to preserve and restore vision.
MATERIALS AND METHODS: Retrospectively 15 patients (13 men/2 women) ranging in age from 17 to 67 years, who were surgically decompressed in the Ear-Nose-Throat Department between 1989 and 1994, were analyzed. Thirteen patients had experienced sudden visual loss after trauma; in 2 patients a tumor was diagnosed. After an initial ophthalmologic examination and CT scans, the patients underwent transnasal decompression of the optic canal for at least 180 degrees. In the postoperative period, visual acuity, pupillary reaction, visual field and optic nerve morphology were monitored.
RESULTS: The overall visual results were poor. In 8 patients with no light perception (NLP) preoperatively, no improvement in visual acuity was found. Minor improvements were seen with an initial vision of 20/200 or less. Dramatic improvements were found in both patients with rapidly progressive neoplastic optic nerve compression. No intra- or postoperative complications were seen.
CONCLUSION: In our study we were unable to reproduce the good visual results of some series. If there is NLP preoperatively, surgical intervention does not seem to be promising. However, in patients with incurable tumors transnasal decompression of the optic canal offers a minimally invasive palliative measure to preserve and restore vision.
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app