影像导航技术在经鼻内镜视神经减压术中的应用  

Application of image navigation assisted nasal endoscopic surgery in optic nerve decompression

作　　者：史丽丽 甄宏韬[1] SHI Lili;ZHEN Hongtao(Department of Otolaryngology Head and Neck Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,430030,China)

机构地区：[1]华中科技大学附属同济医院耳鼻咽喉头颈外科,武汉430030

出　　处：《临床耳鼻咽喉头颈外科杂志》2018年第24期1893-1896,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：华中科技大学教学课题(No:2016082)

摘　　要：目的:探讨影像导航技术在经鼻内镜视神经减压术中的应用及优势。方法:对60例创伤性视神经病患者(间接损伤55例,直接损伤5例)实施影像导航辅助下的经鼻内镜视神经减压术,术后随访6个月～4年,追踪并分析手术治疗效果。结果:术前有光感以上视力的16例患者,术后视力均有提高,其中1例为10cm指数,2例为40cm指数,1例为70cm指数,12例视力为0.04～0.30;其中2例患者存在部分视野缺失;有效率100%。术前无光感的44例患者中,术后11例视力提高,其中4例为光感,可见人影;7例视力在0.03～0.08,其中1例伴视野缺失;有效率25%。所有患者均未出现眶内和颅内并发症。结论:在影像导航系统的指引下,可以快速和精准定位眶尖、视神经管及骨折部位、颈内动脉等解剖标志,从而进行有效的减压,提高手术的精确性和手术成功率。Objective:To explore the application and to evaluate the advantage of image navigation assisted nasal endoscopic surgery in optic nerve decompression.Method:Sixty patients accepted the image navigation assisted nasal endoscopic surgery therapy in optic nerve decompression were included in this retrospective study and followed up for about six months to four years.Result:The visual acuity was improved in 16 cases with visual acuity above light.One case is 10 cm index,two cases are 40 cm index,one case is 70 cm index,the visual acuity of rest 12 cases was between 0.04 and 0.30,two of them were missing from the field of view,the effective rate was 100%.The 44 cases without light sensation before operation,postoperative visual acuity was improved in 11 cases,four of which were light sensation and visible figure.Visual acuity of seven cases was between 0.03 and 0.08,one of them was missing from the field of view,the effective rate was 25%.No complications occurred. Conclusion:With the help of the image navigation,it is convenient and accurate to locate the anatomical marker sites such as orbital apex,optic canal and fracture site,internal carotid artery and so on,as a result,the accuracy and the success rate of the surgery were greatly improved.

关 键 词：影像导航手术 内镜外科手术 视神经减压术 创伤性视神经病 

分 类 号：R774.6[医药卫生—眼科]