Effectiveness of Optic Decompression by Endoscopic Endonasal Approach on Patients with Traumatic Fracture of Optic Canal

摘要

Traumatic fracture of optic canal is a severe injury to the optic nerve and often causes permanent visual loss, and it is difficult to treat. This study is to evaluate the effectiveness of decompression of optic canal by nasal endoscope. Operation of optic canal decompression was performed on 210 cases (212 sides) with traumatic fracture of optic canal. Clinical effectiveness was assessed based on improvement of visual acuity. After following up for 6 months to 2 years, visual improvement with more than one visual acuity level was observed on 101 sides (47.6%). Among them, an excellent effect (increasing 2 levels of visual acuity) was achieved on 72 sides (34.0%). Among 133 sides performed within 5 days of injury, 61 sides (45.9%) showed excellent effect (improved 2 levels of visual acuity). In contrast, when operation was performed after 5 days of injury, only 11 out of 79 sides (13.9%) showed excellent effect with improvement of 2 levels of visual acuity. And the overall effectiveness between the operations were performed within and after 5 days of injury was different significantly ( P < 0.05). Therefore, endonasal endoscopic optic decompression for traumatic optic neuropathy is an effective measure for patients with traumatic optical canal fracture. Operation within 5 days of injury significantly increases the success rate.