| Objectives:The purpose of this study is to explore the effectiveness of navigation combined with endoscopic transnasal optic canal decompression(ETOCD)in the treatment of traumatic optic neuropathy(TON),and to explore the factors that affect the prognosis.Methods:In this research,the patients with the diagnosis of and treated by ETOCD guided by the same Ophthalmologist were collected,who were the patients treated in the Second Hospital’s Orbital Department of Jilin University.Meanwhile,the time range is from December 2017 to December 2020.In addition,this research also carried out the retrospective analysis.81 cases were found to have the complete material(81 eyes),in which the number of the patients with the problem of left eye was 46,and the number of the patients with the problem of the right eye was 35.Thus number of males and females was 72 and 9 respectively with the minimum age of 4,the maximum age of 65,and the average age of 36.46+15.5.The main content of the research is as follows: 1.The description on the distribution of data was made by using the composition ratio and frequency;2.The differences of influencing factors among groups was studied through the adoption of the Fisher’s exact probability method,independent sample t,and chisquare test.The significant differences were found according to the contrast of multiple groups.The comparison between two group was carried out through the use of the exact probability method of Fisher;3.The influencing factors after the operation were analyzed through multi-factor binary logistic regression,it carried out the analysis on the initial vision.By taking a=0.05 as the standard,it has statistical significance with P<0.05.Results:1.The visual acuity improvement rate of the patients was 70.4%;2.Initial visual acuity was an independent factor affecting the final efficacy,OR=0.080(0.022-0.293),P<0.001;3.The curative effect of the no light perception(NLP)group was significantly lower than that of the light perception(LP)group,Hand motion(HM)group and Finger counting(FC)and above group(P<0.05),while there was no statistically significant difference between the last four groups(P>0.05);4.The visual acuity improvement of the initial in light perception(LP)group or above in 7-30 days after surgery was significantly better than that of the group with no light perception(NLP)(P<0.001);5.There was no statistically significant difference in prognosis between different delay time(P=0.447);6.In the delay time ≤7 days group,the diameter of optic nerve tube in the visual acuity improvement group was significantly larger than that in the non-improvement group(t=2.437,P=0.025).There was no statistically significant difference the two items in >7-day delay(t=0.536,P=0.596);7.There was no correlation between optic canal diameter and optic canal fractures and initial visual acuity(all P values>0.05).Conclusions:1.Navigation combined with ETOCD can bring definite benefits to patients with TON;2.The initial visual acuity of light perception and above indicates a good therapeutic effect,and there is no difference in curative effect between groups,but "gender","age","optical canal fracture","delay time",and "optical canal diameter" Unable to provide reference for clinicians and patients in terms of treatment effectiveness;3.Patients with TON may continue to improve their visual acuity after surgery,and patients with initial visual acuity and light perception are more likely to get continuous visual improvement.4.The length of the delay time does not affect the improvement rate of the patients’ vision after surgery,and even patients with the late stage of injury(delay time>7)can benefit from the treatment.5.Within 7 days of injury,the larger diameter of the optic canal may be a protective factor.6.The diameter of the optic canal cannot predict the degree of vision loss when the injury occurs.A fracture of the optic canal does not mean worse initial vision. |
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