Clinical effect of orbit fracture reconstruction under nasal endoscope / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical effect of orbit blowout fracture reconstruction under nasal endoscope.</p><p><b>METHODS</b>Forty-one cases of orbit fracture were reconstructed for lost or damaged orbit under nasal endoscope through maxillary sinus, ethmoidal sinus or the both.</p><p><b>RESULTS</b>Among the 35 cases of orbit blowout fracture, enophthalmos in 33 cases were completely improved, 29 cases were symmetrical to normal eye after operation without diplopia except that 6 cases had slight enophthalmos accompanied with slight diplopia. Among these 6 cases, 4 cases returned to normal without diplopia 6 months after operation. In the 6 cases of orbit non-blowout fracture, 4 cases were symmetrical to normal eye after operation without enophthalmos, diplopia and facial malformation. One case had slight enophthalmos and diplopia, 1 case had slight enophthalmos with slight facial malformation.</p><p><b>CONCLUSIONS</b>The surgery under nasal endoscope is safe and credible. The method can be easily mastered and its complication is less.</p>

Therapeutic efficacy of combined treatment with surgical decompression and drug for traumatic optic neuropathy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the therapeutic efficacy of combined treatment with surgical decompression and drug for traumatic optic neuropathy (TON) and analyze the influential factors.</p><p><b>METHODS</b>A retrospective study on 69 patients (70 eyes) with TON treated with optic canal decompression through transnasal endoscopic approach and drug was conducted. The visual acuity was divided into 5 grades: no light perception (NLP), light perception (LP), hand move, count finger, > 0.02, marked as I-V respectively. Of 40 eyes with grade I, 18 eyes received emergency operation for severe optic canal fracture confirmed by CT; 22 eyes received corticosteroid therapy firstly and then operation. Of 30 eyes above grade I, 16 eyes with optic canal fracture confirmed by CT received emergency operation; 14 eyes received corticosteroid therapy firstly and 3 days later received operation. Postoperative follow-up lasted 3-12 months to observe the recovery of visual acuity.</p><p><b>RESULTS</b>The therapeutic efficacy of patients with the visual acuity of LP and above LP was better than that of NLP (90.0% to 27.5%), the difference had statistical significance (chi(2) = 26.98, P < 0.001). In operated group, the therapeutic efficacy in patients whose visual acuity was improved from NLP after glucocorticoid therapy (80.0%) was better than that of the patients with no improvement (5.9%), the difference had statistical significance (chi(2) = 12.09, P < 0.001).</p><p><b>CONCLUSION</b>The imaging findings of optic canal fracture can not be used as determinants for operation. The patients with NLP whose visual acuity had no improvement after corticosteroid therapy are poor candidates for surgical decompression. The visual acuity before treatment is the main factor affecting the therapeutic efficacy.</p>