Clinical evaluation on nasal endoscopic surgery for rhinogenous optic function damage

Abstract

Objective To evaluate the diagnosis and efficiency of nasal endoscopic surgery treatment for rhinogenous optic function damage (ROFD).Methods The clinical data of 36 patients (36eyes) with ROFD were retrospectively reviewed.All patients were operated on nasal sinus probing and open sinus surgery through transnasal endoscopic approach,and 10 patients underwent endoscopic optic nerve decompression.Results Seven patients had bilateral pansinusitis,9 patients had unilateral posterior ethmoidal sinusitis and sphenoiditis,8 patients had isolated sphenoiditis,8 patients had fungal sinusitis occured in the sphenoid sinus and unilateral posterior ethmoid sinus,3 patients had unilateral pyocyst and cyst of the sphenoid and ethmoid sinus,1 patient had frontal and ethmoidal sinusitis.All patients were confiemed by pathology after surgery.The visual acuity preoperative were as follows:3 eyes no light perception,10 eyes hand movement,11 eyes fingers counting less than 20 cm and 12 eyes were vision impaired in different degree.The visual acuity postoperative were as follows:3 eyes failed,13 eyes cured,20eyes improved from hand movement or fingers counting to fingers counting (30-60 cm).The efficiency rate was 91.7％(33/36).The other eye symptom was disappeared.Sinus epithelization was happened after surgery in all patients.Conclusions If the medicine expectant treatment is invalid,nasal sinus probing and open sinus surgery through transnasal endoscopic approach should be performed early in treatment of ROFD.Patients who suffered frnm severe visual damage and either unresponsive or intolerant to medical treatment should be administrated endoscopic sinus surgery including endoscopic optic nerve decompression. Key words: Vision disorders; Optic neuritis; Endoscopy; Decompression, surgical