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NR 4-6/2008
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Endoskopowe
odbarczenie nerwu wzrokowego u chorych z pourazowymi
zaburzeniami widzenia
Endoscopic decompression of
the optic nerve in patients with post-traumatic vision
impairment
Andrzej Sie¶kiewicz, Tomasz Łysoń1, Zenon
Mariak1, Marek Rogowski
Klinika Otolaryngologii Uniwersytetu Medycznego w Białymstoku
Kierownik: prof. dr hab. n. med. Marek Rogowski
1Klinika Neurochirurgii Uniwersytetu Medycznego w
Białymstoku
Kierownik: prof. dr hab. n. med. Zenon Mariak |
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| Summary: |
Purpose: Traumatic
optic neuropathy (TON) is a dangerous complication of
head trauma but the mechanism of the symptoms still
remains obscure. Moreover, there is no uniformly
accepted treatment protocol for this condition.
Endoscopic, minimally invasive decompression of the
optic nerve in its bony canal is an alternative to
conservative approach.
Material and methods: Endoscopic optic nerve
decompression was performed in 6 patients, whom head
trauma caused blindness or severe impairment of vision.
In 5 of them direct optic nerve injury might have been
suspected due to presence of bony fractures in the
region of the optic canal and the orbital apex. The time
from the trauma to the surgical intervention varied from
8 hours to 30 days. All the patients before the
attempted surgery were treated with steroids, however
the doses and time of this treatment varied
significantly.
Results: There were no complications of the
surgery; all the patients were mobilized on the day of
operation and reported no problems with nasal breathing.
Vision improved in 2 of 6 patients (33.3%),
interestingly both of them had experienced rather
gradually developing deterioration of vision during
several hours after the trauma.
Conclusions: Endoscopic optic nerve decompression
is a minimally invasive and safe procedure to be
employed for optic nerve decompression in patients with
posttraumatic impairment of vision. |
| Słowa kluczowe: |
nerw wzrokowy, pourazowa
neuropatia nerwu wzrokowego, dekompresja endoskopowa. |
| Key words: |
optic nerve, traumatic
optic neuropathy, endoscopic decompression. |
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