A Proposal of Endonasal-Transethmoidal Operation for Optic Canal Decompression and its Clinical Evaluation in 16 Cases

Abstract

The significance of visual disturbances induced by head injuries is well known. It has generally been accepted that impaired vision is chiefly cause by compression of the optic nerve resulting from optic canal fracture which can be caused by a slight blow on the lateral-superior part of the eyebrow. It was considered that the intranasal transethmo-sphenoidal technique was the most reasonable route for the optic nerve decompression without leaving cosmetic handicaps. The present method can be applied either to the cases with clear prominence of the optic canal or to the case with indefinite or less prominent canal wall. In this paper, procedures of the operation were described in details. From 1969 to 1972, 16 cases of visual disturbances following blunt trauma of the head were seen and treated in our otolaryngology department. The incidence was highest in youth under 20 years of age and in motorbike accidents. In 8 cases of incomplete loss of visual acuity, remarkable improvement was obtained after the operation. In 8 cases of complete loss of visual acuity in preoperative stage, the vision did not improve except for 2 cases after the operation.