Clinical research on nasal endoscopic surgery for rhinogenous optic function damage

Abstract

To explore the surgical treatment of rhinogenous optic function damage (ROFD) through transnasal endoscopic approach. Twenty-three patients (25 eyes) with ROFD were retrospectively reviewed. All patients were operated on through transnasal endoscopic approach, and 9 patients underwent endoscopic optic nerve decompression. Four patients had bilateral pansinusitis, 6 patients had unilateral posterior ethmoidal sinusitis and sphenoiditis. One patient had frontal and ethmoidal sinusitis. Five patients had fungal sinusitis occurred in the sphenoid sinus and unilateral posterior ethmoid sinus. Two patients had unilateral pyocyst and cyst of the sphenoid and ethmoid sinus. The preoperative visual acuity preoperative were as follows: 2 patients (2 eyes) no light perception (NLP), 6 patients (7 eyes) hand movement (HM), 7 patients (7 eyes) fingers counting (FC) less than 20 cm and 8 patients (9 eyes) were vision impaired in different degree. One patient (1 eye) was ophthalmoptosis, direct and indirect light reflex vanished. Three patients (3 eyes) diplopia, 2 patients (2 eyes) abduction paralysis, 3 patients (3 eyes) defect of visual field. One patient ptosis of upper lid. The visual acuity postoperative: 2 eyes failed, 10 eyes cured;13 eyes improved from HM or FC to FC (30-60 cm). The endoscopic sinus surgery combined with appropriate medical therapy are effective to ROFD. Patients who suffered from severe visual damage and either unresponsive or intolerant to medical treatment should be administrated endoscopic sinus surgery including endoscopic optic nerve decompression.