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Transnasal Endoscopic Optic Nerve Decompression in Post Traumatic Optic Neuropathy.

Devang Gupta1, Monica Gadodia2

  • 11Civil Hospital, Ahmedabad, India.

Indian Journal of Otolaryngology and Head and Neck Surgery : Official Publication of the Association of Otolaryngologists of India
|February 20, 2018
PubMed
Summary

Surgical optic nerve decompression via a transnasal approach successfully restored vision in 80% of patients with traumatic optic neuropathy unresponsive to conservative treatment.

Keywords:
Impairment in visionOptic nerve decompressionOptic neuropathyPost traumaticTransnasal

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Area of Science:

  • Ophthalmology
  • Neurosurgery
  • Trauma Surgery

Background:

  • Traumatic optic neuropathy (TON) can lead to significant vision impairment or blindness.
  • Conservative management, including steroid therapy, is often insufficient for severe cases of TON.
  • Prompt intervention is crucial to prevent irreversible optic nerve damage.

Purpose of the Study:

  • To evaluate the efficacy of optic nerve decompression in patients with post-traumatic unilateral optic neuropathy.
  • To quantify visual acuity improvement following surgical intervention.

Main Methods:

  • A prospective study involving 20 patients with unilateral TON unresponsive to conservative management.
  • Surgical decompression performed using the transnasal-ethmo-sphenoidal endoscopic approach.
  • Post-operative visual acuity assessed at 1 month, 6 months, and 1 year.

Main Results:

  • Complete visual acuity recovery in 16 (80%) patients.
  • Partial visual acuity recovery in 4 (20%) patients.
  • The endoscopic transnasal approach demonstrated safety with no major complications.

Conclusions:

  • Endoscopic optic nerve decompression is a beneficial treatment for traumatic optic neuropathy unresponsive to steroids.
  • Early surgical intervention can prevent permanent vision loss in TON patients.
  • The transnasal approach provides effective decompression of the optic nerve and surrounding structures.