Document Detail


Salvage optic nerve decompression for traumatic blindness under nasal endoscopy: risk and benefit analysis.
MedLine Citation:
PMID:  18076430     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Transnasal endoscopic optic nerve decompression was recommended to treat traumatic optic neuropathy as an effectively adjunctive procedure. The aim of this study was to assess the risks and benefits of salvage surgical decompression for complete vision loss (no light detection) after failure of mega-dose steroid therapy. DESIGN: Retrospective study. SETTING: Two hospitals in Guangzhou and Nanjing, China. PARTICIPANTS: Forty-two patients of traumatic optic neuropathy with complete vision loss and failed to improve after steroid therapy for at least 3 days. MAIN OUTCOME MEASURES: All patients were treated by transnasal endoscopic optic nerve decompression and received follow-up for at least 6 month. Vision improvement and complications were evaluated. RESULTS: Transnasal endoscopic optic nerve decompression was performed successfully in 40 patients and was incomplete in two patients due to bleeding. Vision improved in four of 42 patients (9.5%) of traumatic optic neuropathy with complete vision loss and failed steroid therapy. Complications and sequelae included severe bleeding (two cases), cerebrospinal fluid rhinorrhea (one case), nasal polyps (seven cases), chronic sinusitis (four cases) and nasal synechia (17 cases). CONCLUSION: Transnasal endoscopic optic nerve decompression was recommended as a minimally invasive, safe procedure, but complications and sequelae of the surgery should not be neglected. Based on the risk and benefit analysis, we conclude that the very poor surgical outcomes of this series do not support endoscopic optic nerve decompression for traumatic blindness.
Authors:
H B Li; J B Shi; L Cheng; O Yun; G Xu
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery     Volume:  32     ISSN:  1749-4486     ISO Abbreviation:  -     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-12-13     Completed Date:  2008-02-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101247023     Medline TA:  Clin Otolaryngol     Country:  England    
Other Details:
Languages:  eng     Pagination:  447-51     Citation Subset:  IM    
Affiliation:
Department of Otolaryngology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
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MeSH Terms
Descriptor/Qualifier:
Adult
Blindness / complications,  surgery*
Chi-Square Distribution
Decompression, Surgical
Endoscopy / methods*
Female
Humans
Male
Middle Aged
Nose
Optic Nerve Injuries / complications,  surgery*
Postoperative Complications
Retrospective Studies
Risk Assessment
Salvage Therapy*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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