创伤性视觉神经病变 - 面骨折模式和管理
Nawal M Shams1, Bashar Hassan, Ferris Zeitouni2
1From the University of Maryland School of Medicine.
Annals of plastic surgery
|January 23, 2026
概括
创伤性视神经病变 (TON) 与特定的面部骨折,特别是状鼻骨折有关. 对TON的类固醇治疗比观察更快,更好地改善视力敏度.
科学领域:
- 眼科医生 眼科 眼科
- 神经外科 神经外科
- 创伤外科 手术 创伤外科
背景情况:
- 创伤性视神经病变 (TON) 可能导致50%的患者永久性视力丧失.
- 诊断和管理TON带来了重大的临床挑战.
- 识别与TON相关的特定面骨折对于早期检测和干预至关重要.
研究的目的:
- 识别与创伤性视神经病变 (TON) 相关的面骨折.
- 为了比较TON患者的视觉结果,通过观察管理与基于类固醇的治疗.
主要方法:
- 对急性面部创伤患者的面骨折CT扫描 (2018-2022) 的回顾性审查.
- 对TON患者结果 (2013-2022) 的分析,将类固醇治疗 (IV甲基prednisolone) 与观察进行比较.
- 用于评估骨折关联和治疗结果的多变量逻辑和线性回归.
主要成果:
- 在2374名面部骨折患者中,有21名 (0.9%) 患有TON.
- 脊柱鼻骨折显示TON的几率最高 (aOR 25),其次是LeFort III (aOR 13) 和NOE骨折 (aOR 7).
- 与观察相比,接受类固醇治疗的TON患者的视力敏度明显改善 (62%对33%) 和57天更快的恢复.
结论:
- 状鼻骨折的患者需要仔细检查TON.
- 与观察相比,在该机构的类固醇治疗导致TON患者的视力改善更快,最终视力敏度更好.
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