The clinical effect of transsphenoidal approach for decompression by nerve endoscopy in optic nerve injury

ZHOU Li-ping; LI Jia; HAO Bing; YUAN Hong-feng

doi:10.3969/j.issn.1009-4237.2018.06.008

Abstract：Objective To observe the clinical effect of transsphenoidal approach for decompression by nerve endoscopy in traumatic optic neuropathy.Methods Clinical data of 19 patients diagnosed as having optic nerve injury in Department of Ophthamology ,Daping Hospital from Nov.2014 to Dec.2016 were analyzed retro-spectively.All of them were male,aged 10～63 years,with an average of 30 years.Preoperative vision was as fol-lows: 7 cases of no light sensation,4 cases of light sensation,5 cases of manual sensation,and 3 cases of finger counting.All patients were treated with methylprednisolone for 500mg and did not improve their eyesight with meth-ylprednisolone treatment.All these patients were treated by transsphenoidal approach for decompression under nerve endoscopy.Decompression range was based on the length of optic canal measured by CT.The clinical therapeutic efficacy and the postoperative visual acuity of these patients were observed and analyzed for 6 months of follow-up. Results Clinical symptoms improved in 11 of the patients after surgery ,with a total efficacy of 57.9%.Of 7 pa-tients who had no light perception ,2 cases (2 eyes) got better after operation ,and the rate of visual acuity improve-ment was 28.6%.Nine patients (9 eyes) in the 12 patients with light perception before operation had improved vi-sion after surgery,with the rate of visual acuity improvement of 75%.The best visual acuity was 0.12.One patient had cerebrospinal fluid leakage after surgery and healed after conservative treatment .No nasal bleeding or paranasal sinusitis occurred.Nineteen patients had no significant changes in visual acuity after six months of follow -up.Con-clusion Transsphenoidal approach for decompression by nerve endoscopy is effective in improving the visual acuity in optic nerve injury patients with minimal invasiveness and few complications ,thus worth of option.