经鼻内镜视神经减压术治疗非外伤压迫性视神经病  

Endoscopic optic nerve decompression for nontraumatic compressive optic neuropathy

作　　者：任成龙[1] 王小路[1] 单希征[1] 

机构地区：[1]武警总医院耳鼻咽喉头颈外科,北京100039

出　　处：《解放军医学杂志》2015年第11期915-920,共6页Medical Journal of Chinese People's Liberation Army

基　　金：武警总医院苗圃基金(WZ2010043)~~

摘　　要：目的探讨经鼻内镜视神经减压术治疗非外伤压迫视神经的临床疗效。方法回顾性分析2013年4月-2014年4月在武警总医院耳鼻咽喉头颈外科行鼻内镜下切除鼻腔颅底肿瘤同时行视神经管减压术的10例患者的临床资料。10例患者中男5例,女5例,年龄44.3±5.1岁,其中5例因肿瘤压迫视神经出现视力丧失,5例因肿瘤压迫视神经出现视力减退。对所有患者术前和术后6个月的临床和影像学资料进行总结分析。结果 5例术前无光感的患者(其中2例为双侧视神经受压)中,术后第7天4例视力有不同程度的提高(双侧视力丧失的患者双侧视力均有提高)。5例术前视力下降患者术后视力均有不同程度的恢复。所有患者术后未见明显并发症。结论经鼻内镜视神经减压术治疗肿瘤压迫视神经是一种安全、有效、创伤小的外科技术,能明显改善非外伤压迫性视神经病患者的视力。Objective To describe the preliminary experience with endoscopic optic nerve decompression（EOND） for nontraumatic compressive optic neuropathies（NCONs）. Methods The clinical data of 10 patients, male 5 and female 5, with a mean age of 44.3±5.1 years, who underwent EOND for visual loss（n=5） or visual deterioration（n=5） due to tumor compression in General Hospital of Armed Police Forces of China in the period from April 2013 to April 2014 were analyzed retrospectively. Preoperative and 6-month-postoperative clinical and imaging data of these patients were reviewed and analyzed. Results Among 5 patients who lost light perception（including 2 patients with bilateral optic nerve compression） before operation, 4 of them showed visual improvement to different degrees on the 7th day after operation（with improvement of bilateral visual acuity）. The other 5 patients with visual impairment before operation recovered their visual acuity to different extent after the operation. All of the patients had no obvious post-operative complications. Conclusion EOND is a safe, effective, and minimally invasive surgical technique affording recovery of visual function to NCON patients.

关 键 词：盲 颅底肿瘤 视神经减压 

分 类 号：R739.41[医药卫生—肿瘤] R774.6[医药卫生—临床医学]