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Extracranial optic nerve decompression for traumatic optic neuropathy
M P Joseph1, S Lessell, J Rizzo
1Department of Otology and Laryngology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston 02114.
Archives of Ophthalmology (Chicago, Ill. : 1960)
|August 1, 1990
Summary
Transethmoid-sphenoid optic canal decompression safely treats acute optic nerve trauma from head injuries. This surgical approach improved vision in 11 of 14 patients, including those with severe pre-operative vision loss.
Area of Science:
- Ophthalmology
- Neurosurgery
- Trauma Surgery
Background:
- Blunt head trauma can cause acute, unilateral optic nerve injury.
- Optic nerve decompression is a potential treatment for vision loss after trauma.
- The transethmoid-sphenoid approach offers access to the optic canal.
Observation:
- Fourteen patients with acute optic nerve injury post-head trauma were studied.
- All patients underwent ipsilateral external ethmoidectomy for optic canal decompression.
- Perioperative dexamethasone treatment was administered to all participants.
Findings:
- The transethmoid-sphenoid optic canal decompression procedure resulted in no observed morbidity or mortality.
- Eleven out of fourteen patients experienced improved vision following the intervention.
- Significant visual recovery was noted in 3 patients who were initially unable to perceive light.
Implications:
- Transethmoid-sphenoid optic canal decompression is a safe and effective surgical option for indirect optic nerve trauma.
- This minimally invasive technique can restore vision in patients with traumatic optic neuropathy.
- Further research should explore long-term outcomes and patient selection criteria for this procedure.