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Journal of Korean Neurosurgical Society 1997;26(6): 874-878.
Endoscopic Optic Nerve Decompression in Traumatic Optic Neuropathy.
In Young Kim, Jae Hyoo Kim, Jung Kil Lee, Tae Sun Kim, Soo Han Kim, Sam Suk Kang, Je Hyuk Lee, Jae Shik Cho, Sung Ju Kim
1Department of Neurosurgery, Chonnam University Hospital & Medical School, Kwangju, Korea.
2Department of Otolaryngology, Chonnam University Hospital & Medical School, Kwangju, Korea.
3Department of Ophthalmology, Chonnam University Hospital & Medical School, Kwangju, Korea.
ABSTRACT
Traumatic optic neuropathy is a challenging emergency; controversies involving definition, natural history, pathomechanisms, and treatment modalities make its management problematic. Surgical decompression does not always yield favorable results; if this approach is considered, however, a careful evaluation of the necessary extent of invasion, the patient's condition(including a compromised brain) and the surgeon's familiarity with the procedure must all be carefully considered. We managed two traumatic optic neuropathy patients whose vision had been lost after fracture of the medial orbital wall. Using a nasal endoscope, the endonasal approach was employed, and endoscopic optic nerve decompression was performed; visual acuity was partly recovered. This precedure can be used in patients with decreased visual acuity due to traumatic optic neuropathy involving fractures of the optic canal. It is considered minimally invasive, has no specific contraindication, and can be used in patients whose brain condition is compromised.
Key Words: Endoscopic optic nerve decompression; Traumatic optic neuropathy
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