Efficacy of comprehensive optic canal decompression for traumatic optic nerve injury with no light perception
10.11855/j.issn.0577-7402.1705.2023.0619
- VernacularTitle:全方位视神经管减压治疗无光感外伤性视神经损伤的疗效
- Author:
Xin-Yu LI
1
;
Xi-Tao YANG
;
Zhi-Lin GUO
Author Information
1. 上海交通大学医学院附属第九人民医院神经外科,上海 201999
- Keywords:
traumatic optic nerve injury;
decompression of optic nerve canal;
treatment;
prognosis
- From:
Medical Journal of Chinese People's Liberation Army
2024;49(2):177-181
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical effect of total optic nerve canal decompression in the treatment of traumatic optic neuropathy(TON)without photoreceptor.Methods The clinical data of 67 patients with no photoreceptor TON admitted to Department of Neurosurgery of the Shanghai Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine from January 2015 to December 2021 were selected for retrospective analysis,in which 37 cases in observation group received total optic nerve canal decompression surgery and 30 cases in control group received non-total optic nerve canal decompression surgery.Both groups received high-dose glucocorticoid therapy and oral administration of methylcobalamin before surgery.The visual acuity changes and complications after admission and treatment were examined and recorded in both groups.The effective rate,unblinding rate and complications after treatment were compared between the two groups.Results There were no statistically significant differences between observation group and control group in terms of age,gender,time from injury to surgery,preoperative GCS score,operative time,and intraoperative bleeding volume(P>0.05).After treatment,the effective rate of observation group was 54.1%and the unblinding rate was 35.1%,while the effective rate of control group was 46.7%and the unblinding rate was 33.3%;there was no statistically significant difference between the effective rate and unblinding rate of the two groups(P>0.05).No serious complications such as cerebrospinal fluid leakage,epilepsy,and intracranial infection occurred in both groups after surgery.In observation group,the effective rate after treatment was significantly lower in those with optic nerve canal fractures than that in those without optic nerve canal fractures(P<0.05);the effective rate was significantly higher in patients with injury-to-operation time≤7 d than that in patients with injury-to-operation time>7 d(P<0.05).Conclusion Total optic nerve canal decompression can improve the visual acuity of patients without photoreceptor TON and reduce the blinding rate,which is an effective surgical treatment method.
