Timing of endoscopic surgical decompression in traumatic optic neuropathy: a systematic review of the literature

International Forum of Allergy & Rhinology
Sandeep S DhaliwalBrian W Rotenberg

Abstract

Traumatic optic neuropathy (TON) represents a rare but devastating complication of closed head injuries. No accepted guidelines are available for medical and surgical management algorithms. A systematic review of the literature was performed to determine the optimal timing and candidacy for endoscopic surgical intervention. A systematic review of multiple databases was performed including Medline-Ovid, EMBASE, and PubMed. Data was extracted and patients stratified based on surgical delay from trauma (≤3 days, >3 days, ≤7 days, or >7 days) as well as preoperative and postoperative vision testing (no light perception [NLP]; light perception [LP]; hand motion [HM]; or finger counting [FC] or better). The literature review identified 24 studies meeting inclusion criteria. In the group of patients receiving surgery ≤3 days after the antecedent event, 57% (105/183) had visual improvement, whereas in the >7-days group 51% (145/283) of patients improved. In those with NLP preoperatively, 41% (172/411) saw improvement, whereas those with LP (89%), HM (93%), or FC (85%) fared better. The literature suggests that surgical intervention for TON is indicated despite delayed presentation, and is a better choice than no intervention at all. Pa...Continue Reading

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Citations

Jul 23, 2019·International Forum of Allergy & Rhinology·Eric W WangCarl H Snyderman
Nov 8, 2018·Korean Journal of Neurotrauma·Hyuk-Jin OhSun-Chul Hwang
Jul 7, 2020·The Annals of Otology, Rhinology, and Laryngology·Jingwen SunJiaxiong Zhang
Feb 24, 2020·Neurosurgical Review·Rafael Martinez-PerezDaniel M Prevedello
Jun 8, 2017·The Journal of Craniofacial Surgery·Daoyu XieLi Zhang
Feb 22, 2021·Journal of Neuro-oncology·Rafael Martinez-PerezDaniel M Prevedello
Mar 18, 2021·Journal of Ophthalmology·Saeed KarimiSare Safi

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