Treatment options for traumatic abducens nerve injury: a dual-center clinical experience

Abstract

Objective: This study aimed to assess the therapeutic efficacy of surgical and conservative treatments in patients with traumatic abducens nerve injury on neurofunctional recovery based on dual-center clinical experience. Methods: A retrospective analysis was conducted on the clinical data of 71 patients with traumatic abducens nerve injury. Patients were categorized into the operation group and the conservative treatment group based on whether patients underwent surgical intervention during their hospitalization. A comparison was made between the two groups regarding ocular motility recovery before and after treatment. In addition, patients were further divided into complete paralysis and incomplete paralysis groups based on their initial ocular position score for subgroup analysis. Results: The overall effective rate of conservative treatment group was 81.82%, while the overall effective rate of operation group was 88.89%. there is no statistically significant difference (χ2=0.173, P=0.678) between two groups. Subgroup analysis indicated that both in the conservative treatment group and in the surgical group, the efficacy rate is significantly lower in the complete paralysis subgroup compared to the incomplete paralysis subgroup. Results showed the total effective rate was 92.31% vs .66.67%（χ2=4.70, P<0.05） on conservative treatment group and 100% vs .66.67% （χ2=3.857, P<0.05）on operation group. Conclusion: The total effectiveness rate of the conservative treatment group was similar to that of the operation group, suggesting no difference in treatment effectiveness between two treatment plans, and the prognosis of traumatic abducens nerve injuries remains favorable. However, the higher the initial ocular position score of the patient, the more severe the paralysis symptoms, and the worse the treatment effect. Thus, treatment choices should be individualized to ensure optimal results.