Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Leitner, I.
Transnasal endoscopic decompression of the optic nerve.
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2020. pp. 57
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Köle Wolfgang
- Tomazic Peter Valentin
- Altmetrics:
- Abstract:
- Introduction: The transnasal endoscopic decompression of the optic nerve is a surgical method which can decrease pressure on the nerve and prevent further damage after injury. The main causes for a compression are accidents which lead to skull fractures and expansive procedures such as tumors. Besides conservative therapy such as steroids and intracranial approaches, endoscopic decompression is a well-established method. In the international literature opinions on which parameters influence the visual outcome of the patients differ a lot. The objective of this study was to analyze several parameters and draw conclusions which may help to improve and adapt treatment options for future cases. Material and methods: In this study, data from patients at the Department of Otorhinolaryngology at the Medical University of Graz were collected who underwent an optic nerve decompression between 1 June 2001 and 18 November 2018. In total, 62 patients fulfilled the inclusion criteria and 32 underwent an endoscopic decompression. They were considered for the main analysis. Retrospectively collected data were statistically analyzed to compare parameters that favor visual improvement after surgery. Results: The use of steroids did not show a benefit in visual outcome. On the contrary, in the group of patients with no steroid treatment more patients (66.67%) improved in vision as in the group with steroid treatment (31.25%) (p=0.049). Patients with an injury of the nerve proven in radiological imaging before surgery had a higher recovery rate (66.67%) in comparison to the group with a normal optic nerve (28.57% improved) in their scans (p=0.033). Conclusions: Considering the success rate of vision recovery (50%) after endoscopic decompression surgery, the establishment of a standard guideline for optic nerve compressions would be an important future target to improve the success rate. As a conclusion, the radiological findings as indicator for surgery might help to avoid non-beneficial surgeries. Moreover, the use of steroids should be considered more carefully and investigated with further studies analyzing their feasibility. Surprisingly, no strong correlation was observed regarding the timing of surgery. Since our study group was small and immediate surgery in a short time frame is recommended by several authors, the general recommendation for immediate surgery should remain valid.