Clinical Observation Of Traumatic Optic Nerve Injury With Endoscopic Optic Canal Decompression And Simple Steroid Pulse Therapy

Objective:Through Comparing of the clinical efficacy between Endoscopic optic nerve decompression combined with steroid and simple Steroid treatment of primary traumatic optic nerve injury, and to explore the feasibility and advantages or disadvantages of the two treatment methods, Convenient for choose the more reasonable treatment programs in clinical treatment to improve the prognosis of the disease and ultimately reducing morbidity of primary traumatic optic nerve injury, and improve their quality of life.Methods:THE cases for researching compare of 54 patients with primary traumatic optic nerve injury who treated in Shanxi Da Hospital neurosurgery from March 2012 to October 2015. all patients were consistent with the study inclusion criteria. All surgeries were performed by neurosurgeon who have more than 3 years of experience of endoscopic surgery. Patients with steroid therapy but effective will undergo surgery to determined the surgery-steroid group, 26 patients eventually underwent surgery;Patients with steroid treatment is effective and ineffective but unwilling to accept operation to determined the simple steroid group, 28 patients eventually underwent steroid therapy. The general information including gender, age, the location of suffering eye, optic canal fracture or not, have amplitude or not in VEP check in two groups will be compared to ensure comparability in two data.Collect and record visual acuity after treatment in 1、3、6、10、12 months, According to no-light-perception,light- perception, hand motion front eye, refers to the number front eye and visible the eye chart(0.04 and above international standards) five levels to assessment, improveone level is effective, visible the eye chart is effective vision,no increase is considered invalid.Use SPSS13.0 statistical software to calculate collected data,count-data in the form of rate(%),which were compared with χ2 test or Fisher’s exact test; For level data or missing measurement data variance, rank sum test was used to compare; repeated measures data was used to compare with analysis of variance.Significance α = 0.05.Results:The general data of surgery-steroid group and simple steroid group were not statistically significant(P>0.05), having comparable performance.Endoscopic optic nerve decompression combined with steroid in patients followed up for 3-12 months,There are 9 cases have improved in visual acuity,6 cases get light perception,3 cases get practical vision, and the remaining 17 cases ineffective, the total effective rate was 34.6%, 11.5% restore useful vision. In simple steroid group, 3 cases have improved in visual acuity, but did not get effective vision, there is only light perception,the rest of the 25 cases ineffective, the total effective rate was 10.7%. For the surgery-steroid group and the effect of the steroid group,there is a difference by X2 test, P <0.05, the difference was statistically significant, endoscopic optic nerve decompression combined with steroid treatment of primary optic nerve injury is better than simple steroid therapy.Conclusion:Primary traumatic optic neuropathy is not taboo for optic nerve decompression,endoscopic optic nerve decompression combined with steroid may be more effective than simple steroid for primary TON,endoscopic optic nerve decompression with small wound、healing fast,without leaving scars, fewer complications and worth promoting.