PMID: 9556715Apr 29, 1998Paper

Early trans-sphenoid decompression in indirect traumatic optic neuropathy

HNO
J M SchmidbauerE Robinson

Abstract

Indirect traumatic optic neuropathy represents a severe, potential vision-threatening disease process that requires close interdisciplinary cooperation for treatment. In general, any therapy has been discussed controversially in the literature. Based upon experiences with spinal cord trauma, high-dose steroid therapy is recommended initially to minimize secondary consequences following orbital trauma. The usefulness of surgical decompression of the optic nerve has been confirmed in several studies but is still not recommended in principle. In nine consecutive patients with known indirect traumatic optic neuropathy and marked losses of vision, transsphenoidal optic decompressions were carried out with simultaneous systemic megadose steroid therapy. A postoperative increase in visual acuity from 1/35 to 10/20 occurred in five patients, while no improvement in visual acuity could be achieved in the other four patients. Previous reports have indicated that some authors will not recommend surgical decompressions if a loss of sight or no light perception occurs directly after an accident. This situation was seen in seven of our patients. The visual acuity of four patients remained no light perception in spite of surgical treatment. I...Continue Reading

Citations

Feb 24, 2001·The Laryngoscope·B LübbenU Grenzebach

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