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[Primary optic nerve decompression in mid-face fractures].

J Messerli1, T Vuillemin, J Raveh

  • 1Univ.-Augenklinik, Inselspital, Bern.

Klinische Monatsblatter Fur Augenheilkunde
|May 1, 1990
PubMed
Summary
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Severe mid-face fractures can damage the optic nerve. Early optic nerve decompression in patients with afferent pupillary defect improved vision in many cases, demonstrating its safety and efficacy.

Area of Science:

  • Ophthalmology
  • Neurosurgery
  • Trauma Surgery

Context:

  • Severe craniofacial-frontobasal injuries frequently involve optic nerve damage.
  • Afferent pupillary defect (APD) is a key indicator of optic nerve compromise.

Purpose:

  • To report findings and visual outcomes in patients with severe mid-face fractures undergoing primary optic nerve decompression.
  • To evaluate the efficacy of subcranial optic nerve decompression in preserving vision.

Summary:

  • Twenty-one patients with severe mid-face fractures and APD underwent primary optic nerve decompression.
  • Optic canal fractures were identified in 13 patients, with bone fragment removal in 6.
  • Nine eyes remained blind, while nine regained good visual acuity (0.5-1.0).

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Impact:

  • Optic canal fractures and bone fragments are significant causes of optic nerve damage in mid-face trauma.
  • Primary subcranial optic nerve decompression is a safe and effective strategy to prevent secondary optic nerve damage and improve visual outcomes.