[Long-term efficacy of nasal endoscopic opticnerve decompression for traumatic optic neuropathy].

Objective: To analyze the long-term efficacy of nasal endoscopic opticnerve decompression for traumatic optic neuropathy(TON) and to explore its possible influencing factors.

Method: To summarize the clinical data of 39 cases underwent transnasal decompression, which were followed-up for more than 1 year. The data, including optic canal CT scanning, flashed-elicited visual-evoked potential (FVEP), preoperational vision and visual field examination were reviewed. Nasal endoscopic optic nerve decompression was preformed. Whether or not optic nerve sheath incision decided to perform was according to preoperative CT and situations in operation. Postoperative follow-up including vision, visual field, funduscopy, nasal endoscopy were performed.

Result: Total efficacy rate was 30. 77% (12/39), inefficacy rate was 69. 23%(27/39). The efficacy rate was 85. 71% with better than nolight perception, and the efficacy rate was 18. 75% with nolight perception, the clinical effect in the group of preoperative better than nolight perception was better than that of nolight perception, the difference was statistically significant (P<0. 05). The efficacy rate was 34. 38% with duration of less than 7 days from the traumatic point to the operation point, and the efficacy rate was 14. 29% for more than 7 days, but the difference was not statistically significant (P> 0. 05). The efficacy rate was 26. 32% with optic nerve sheathincision, while the efficacy rate was 35. 00% without optic nerve sheath incision, and there was no statistically significant difference (P>0. 05); Postoperative vision tended to stabilize until about 6 months post-operation, without complications.

Conclusion: The long-term efficacy of nasal endoscopic opticnerve decompression for TON was certain; The efficacy with preoperative residual vision was better than that of nolight perception, the factor of long or short duration from the trauma point to the operation point and the factor of optic nerve sheath incision didn't influence long curative effect. To avoid the secondary damage to the optic nerve after trauma was the key to increase long curative effect in TON.