CAJ | 학술논문

目的探讨视神经管狭窄减压术治疗累及视神经管的骨纤维发育不良的机制、方法、效果及时机.方法对18例以每侧眼为单位患者行视力、CT、眼底像、OCT检查,手术组21侧行经颅硬膜外入路,其中19侧切除视神经管上壁、外侧壁和内壁病变,另有2侧切除视神经管眶口病变；非手术组15侧随访,其中1侧视力下降后手术.对不同组的视力变化进行非参数检验.结果治疗性手术组15侧,视力有效率14/15,预防性手术6侧,视力不变(P=0.012),视神经管再次狭窄5侧,其中视力下降1侧(P=o.080).OCT改变符合筛板压力失衡原理.结论在筛板压力失衡原理指导下,采取经颅硬膜外入路切除视神经管上壁、外侧壁和内壁病变,预防视神经二次损伤效应,可以改善和稳定视力.
목적 탐토시신경관협착감압술치료루급시신경관적골섬유발육불량적궤제、방법、효과급시궤.방법 대18례이매측안위단위환자행시력、CT、안저상、OCT검사,수술조21측행경로경막외입로,기중19측절제시신경관상벽、외측벽화내벽병변,령유2측절제시신경관광구병변；비수술조15측수방,기중1측시력하강후수술.대불동조적시력변화진행비삼수검험.결과 치료성수술조15측,시력유효솔14/15,예방성수술6측,시력불변(P=0.012),시신경관재차협착5측,기중시력하강1측(P=o.080).OCT개변부합사판압력실형원리.결론 재사판압력실형원리지도하,채취경로경막외입로절제시신경관상벽、외측벽화내벽병변,예방시신경이차손상효응,가이개선화은정시력.
Objective To evaluate the mechanism,methods and effects about decompression of stenosis involving optic canal due to fibrous dysplasia through transcranial epidural approach.Method The examination of visual acuity,CT,fundus and OCT of 18 patients of stenosis involving optic canal due to fibrous dysplasia were performed.The patients were divided into 2 groups:operation group and non -operation group.The operation was performed through transcranial epidural approach in 19 sides of optic canals on the upper,outer and inner walls,and 2 sides of optic canals on orbital mouth bones.In non - operationgroup with follow - up,1 eye vision was decreased and then performed operation.Both groups were taken with non - parametric test for vision changes.Results At operation group,the vision was improved( P =0.012),and with recurrence of 5 sides of optic canal stenosis,the visual acuity was decreased in 1 eye ( P =0.080 ).Conclusions With diseqailibrium pressure between lamina cribrosa,transcranial epidural approach for resection of fibrous dysplasia at the upper,outer and inner walls of optic canal could prevent from secondary effect of optic nerve damage and improve and stabilize vision.