Abstract
Iu our clinic of ophthalmology and otolaryngology of Hyogo College of Medicine, 20 cases of retrobulbar optic nerve damage due to head injury were encountered during April, 1973 to June, 1978. Optic nerve decompression surgery performed for 17 of them endonasally and 3 were treated conservatively. Visual improvement were obtained 11 out of 17 (64%) for the former and 2 out of 3 (67%) for the latter respectively.
As the statistical comparison between the two types of treatment were difficult because of shortage in number of the latter, only the results of operative cases were discussed, and disclosed that preoperative radiography does not have necessarily the diagnostic value; i. e. one out of 17 were found to be false positive and 3 out of 6 were false negative and four were uncertain cases. From these results, the more precise radiographical diagnosis of the optic bony canal should be developed in future.
One hundred percent of visual remission was observed in 2 cases in which the bony fragment of optic canal was present when the paranasal sinuses was entered endonasally. Also fifty percent (4 out 8) was the visual improvement ratio for the presence of only the bony fracture line, and seventy-one percent (5 out of 7) for the intact bony canal.
These results may show that even with intact bony canal, the decompression surgery should be necessary to the visual improvement. The data of several other authors including present series showed that the earlier the decompression surgery taken, the more effective the ratio of remission, especially when operations were done within 7 days to the blind.
