Optic Nerve Decompression in the Comatose and Conscious Patients After Trauma

Lübben, B.; Stoll, Wolfgang; Grenzebach, Ulrike

doi:10.1097/00005537-200102000-00025

Cited by 26 publications

(16 citation statements)

References 20 publications

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“…The authors chose the surgical opportunity by mainly relying on results of preoperative ophthalmologic examinations, high-resolution HRCT and the Glasgow Coma Scale. When the scale was C13 points [10][11][12], the surgery should be carried out as soon as possible. The authors observed that (1) For patients with injuries to I, III, IV, V and VI cranial nerves and brain contusion, not only their III, IV, V and VI cranial nerves function recovered well, but their eyesight also recovered relatively well, which may be related to the following mechanism: when acted upon by an external force, the brain was injured, which prolonged the action time of the force upon the optic nerve and lessened the indirect damage to the nerve.…”

Section: Discussionmentioning

confidence: 99%

Study on the treatment of traumatic orbital apex syndrome by nasal endoscopic surgery

Xiao

et al. 2010

Eur Arch Otorhinolaryngol

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Orbital apex syndrome (OAS) is a complex disease caused by a variety of pathological factors, and trauma is one of the main factors/causes. Clinical data of 17 cases of traumatic OAS treated by nasal endoscopic surgery in our department from January 2002 to April 2009 were gathered and reviewed. Among them, the six patients presented with OAS after injury to the lateral wall of orbital apex. Seven other patients exhibited OAS after injury to the medial wall of orbital apex, two displayed OAS after zygomatic trauma, while OAS manifested in the other two patients with craniocerebral trauma 3 days after they had decompressive craniotomy--of them, one was blind in both eyes. In the 17 cases, 6 patients were without light sensation, 1 was blind in both eyes; the sight-chart index of eight patients was 0.1, that of three other patients was 0.1-0.2. Fifteen patients displayed eyeball movement disturbance (disorder) and cornea sensory disturbance (disorder), two were with the eyeball abducent disturbance. After the nasal endoscopic surgeries for OAS performed on the 17, the sight of the most patients was restored in varying degrees. The sight of nine patients was between 0.2 and 0.3, that of two patients was between 0.1 and 0.2, that of the other two patients was 0.1, and that of four patients remained unchanged. The eyeball movement and the cornea esthesia in 15 patients recovered from the surgeries, one patient recovered with good eyeball adducent movement and the cornea esthesia but with eyeball abducent disturbance, the other patient did not make a recovery from the eyeball immobility, cornea anesthesia and ptosis. A follow-up lasting 2 months to 2 years suggested that the 16 patients had stable recovery from the surgeries. Satisfactory results could be achieved in the treatment of traumatic OAS by nasal endoscopic surgery. From objective assessment of the therapeutic effects of traumatic OAS, it can be concluded that if a patient is diagnosed with fractures of the optic canal and the superior and medial walls of orbital apex, nasal endoscopic decompression of superior and medial walls of orbital apex and optic canal via the approach to the sphenoid and ethmoid sinuses is the most ideal operative therapy.

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Section: Discussionmentioning

confidence: 99%

Study on the treatment of traumatic orbital apex syndrome by nasal endoscopic surgery

Xiao

et al. 2010

Eur Arch Otorhinolaryngol

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“…Various options include highdose [12] or low-dose [18] corticosteroids, immediate decompression of the canalicular portion of the optic nerve [17], decompression of the canalicular optic nerve after a course of systemic corticosteroids [8,15], observation and optic-nerve sheath fenestration in cases of anterior TON [7]. In a comparative nonrandomized interventional study, Levin et al [5] found no clear benefit for either corticosteroid therapy, optic canal decompression, or observation in the treatment of TON.…”

Section: Introductionmentioning

confidence: 99%

High-dose intravenous methylprednisolone in recent traumatic optic neuropathy; a randomized double-masked placebo-controlled clinical trial

Entezari

Rajavi

Sedighi

et al. 2007

Graefes Arch Clin Exp Ophthalmol

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“…Thus, even slight longitudinal deformation of the optic canal can stretch or compress the nerve and result in trauma to the axons or vascular supply. 3 Hematoma, thrombosis, and edema within and around the nerve then develop. In addition, trauma may fracture the optic canal or the anterior clinoid processes and produce bone fragments that impinge on the optic nerve.…”

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confidence: 99%

Traumatic optic neuropathy in children and adolescents

Goldenberg-Cohen

Miller

Repka

2004

Journal of American Association for Pediatric Ophthalmology and

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Optic Nerve Decompression in the Comatose and Conscious Patients After Trauma

Abstract: The results confirm our concept of early decompression of the optic nerve, based on close interdisciplinary cooperation and the ophthalmological findings.

Cited by 26 publications

References 20 publications

Study on the treatment of traumatic orbital apex syndrome by nasal endoscopic surgery

Study on the treatment of traumatic orbital apex syndrome by nasal endoscopic surgery

High-dose intravenous methylprednisolone in recent traumatic optic neuropathy; a randomized double-masked placebo-controlled clinical trial

Traumatic optic neuropathy in children and adolescents

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