[Surgical treatment for bilateral traumatic optic neuropathy through intranasal endoscopic approach]

This study was aimed to explore the necessity of nasal endoscopic operation for bilateral traumatic optic neuropathy.

Four patients with complete blind resulted from traumatic impairment of bilateral optic nerves were selected to receive a combined treatment of nasal endoscopic optic nerve decompression (NEOND) with all-around medication.

The vision of all patients was improved except one who lost vision immediately after trauma. Thirty days after injury, patient 1 was treated with NEOND, and the vision of left eye was restored to 1.5, however, the vision of right side was just from light perception (LP) to hand motion (HM). Patient 2 was treated with NEOND 3 days after injury, and the vision was improved from LP to 0. 2 in left side, no change in right eye. The operation of patient 3 was performed 6 days after injury, but no improvement was observed in both visions. Patient 4 received NEOND 28 days after injury, the vision was improved in both sides with left eye from NLP to 0. 8 and right eye from NLP to 0.2.

NEOND can be regarded as an effective treatment for bilateral traumatic blindness, even delayed NEOND may be effective. Both gradual vision loss and residual vision should be the indications for an effective NEOND, but immediate blindness after injury might be the index for poor result of NEOND.