关键词: 视神经损伤, 减压术, 外科, 骨纤维发育不良

Abstract:

Objective To retrospectively analyze the effect of optic canal decompression in 36 patients of fibrous dysplasia from August 1998 to August 2007.
Methods Endocrine examination, ophthalmologic examination and computed tomographic(CT) examination were applied to evaluate the patients preoperatively. All the patients in this group received surgery of transcarnial optic canal decompression under microscope.
Results The pathological diagnosis of each case was fibrous dysplasia. All the patients had CT scan and reconstruction in bone window. Twenty-one cases had unilateral optic canal stenosis, 15 cases had bilateral optic canal stenosis. Eighteen cases had MRI, main part of lesion was in anterior and middle fossa, and slight or medium enhancing after injection of contrast medium. All the patients were followed up from 3 months to 7 years, 38 months in average. Twenty sides(19 cases) had visual improvement 1 week after surgery, 21 sides(15 cases) had no change in eye sight; 2 sides(2 cases) had visual deterioration. One case had Rollet’s Syndrome, 1 case became blind after surgery. Cases who were blind before surgery had no improvement after the treatment. Follow-up after surgery (more than 1 year) in the improved group and stable group showed that 1 case and 3 cases respectively had visual deterioration.
Conclusion Transcranial optic canal decompression showed more satisfactory effects in those who suffered visual acuity impairment caused by fibrous dysplasia in cranial-orbital area.

Key words: optic nerve injuries, decompression, surgical, fibrous dysplasia of bone