摘要
目的探讨经颅硬膜外入路治疗双层壁视神经管视神经损伤中的手术方法及效果。方法选择6例经CT证实双层壁视神经管的视神经损伤患者，经颅硬膜外入路，切除气化筛窦构成的眶上壁至视神经管眶口，显微镜下切除气化的视神经管上壁，切断筛后动脉，自额筛缝之前咬除眶尖骨质及视神经管上壁、内侧壁和外侧壁，减压周径大于1／2而小于3／4，未剪开视神经鞘，封闭蝶窦及后组筛窦的漏口。结果6例患者均有效，其中3例视力达0．1及以上，无脑脊液漏，颅内感染。结论经颅硬膜外入路双层壁视神经管减压术是针对视神经管变异为双层时的有效治疗，具有减压范围充分的特点。视神经损伤患者为双层壁视神经管时应积极手术治疗。
Objective To evaluate the method and effectiveness of transcranial epidural decompression of double wall around optic canal of optic nerve injury. Methods Six patients with double wall around optic canal found by CT were operated： the upper wall of paries superior orbitae construtived with pneumatolysis ethmoid sinus was resected to orbital opening through transcranial approach. While microscope was taken, the upper wall of optic canal was resected and then the bone wall of orbital apex and optic canal from above frontoethmoidal suture were exsected. The upper, inner, and lateral wall were cut off; so that the circumference from 1/2 to 3/4 was decompressed. The optic nerve sheaths was not turn on. The leak of sphenoid sinus and ethmoid sinus was sealed off. Results All 6 patients were effective including 3 patients whose visual activity over 0. 1. Conclusions Transcranial decompression of double wall around optic canal is effective：its decompressed area is sufficient. This kind of patients should be operated in order to improve vision.
出处
《国际外科学杂志》
2008年第2期99-102,F0003,共5页
International Journal of Surgery
关键词
视神经
视神经管
减压术
optic nerve
optic canal
decompression
