頬骨骨折による外傷性視神経症の1例 A case of traumatic optic neuropathy induced by a zygomatic bone fracture

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著者

    • 大久保 拓馬 OKUBO Takuma
    • 名古屋第一赤十字病院歯科口腔外科 Department of Oral and Maxillofacial Surgery, Japanese Red Cross Nagoya First Hospital
    • 佐藤 春樹 [他] SATO Haruki
    • 名古屋第一赤十字病院歯科口腔外科 Department of Oral and Maxillofacial Surgery, Japanese Red Cross Nagoya First Hospital
    • 橋本 健吾 HASHIMOTO Kengo
    • 名古屋第一赤十字病院歯科口腔外科 Department of Oral and Maxillofacial Surgery, Japanese Red Cross Nagoya First Hospital
    • 長縄 陵亮 NAGANAWA Ryosuke
    • 名古屋第一赤十字病院歯科口腔外科 Department of Oral and Maxillofacial Surgery, Japanese Red Cross Nagoya First Hospital
    • 大岩 伊知郎 OH-IWA Ichiro
    • 名古屋第一赤十字病院歯科口腔外科 Department of Oral and Maxillofacial Surgery, Japanese Red Cross Nagoya First Hospital

抄録

Traumatic optic neuropathy (TON) involves various grades of vision loss or deterioration without ocular injury following facial trauma. Causes of TON include direct optic nerve injury, fractured bone fragments, optic nerve ischemia, and optic nerve compression by hematoma or edema. We treated a 78-year-old woman with impaired left visual acuity caused by optic nerve compression by the fragments of a left zygomatic bone fracture.After detailed optic examinations by an ophthalmologist and neurosurgeon in the departments of ophthalmology and neurosurgery, open reduction and fixation were performed about 27 hours after injury. The patient gradually recoved from TON and had no severe complications after the operation. Although the management of TON remains controversial, many reports suggest that there is no significant difference in outcomes between surgical treatment and non-surgical treatment. However, zygomatic bone fracture with clinically significant dislocation or nerve impairment is generally an indication for surgical reduction. Since few reports have documented exacerbation of visual acuity after open reduction and fixation, operation should not be delayed in patients with no systemic problems. Consideration of optic functions and consultation with related departments are essential when treating patients with mid-facial fractures.

Traumatic optic neuropathy (TON) involves various grades of vision loss or deterioration without ocular injury following facial trauma. Causes of TON include direct optic nerve injury, fractured bone fragments, optic nerve ischemia, and optic nerve compression by hematoma or edema. We treated a 78-year-old woman with impaired left visual acuity caused by optic nerve compression by the fragments of a left zygomatic bone fracture.After detailed optic examinations by an ophthalmologist and neurosurgeon in the departments of ophthalmology and neurosurgery, open reduction and fixation were performed about 27 hours after injury. The patient gradually recoved from TON and had no severe complications after the operation. Although the management of TON remains controversial, many reports suggest that there is no significant difference in outcomes between surgical treatment and non-surgical treatment. However, zygomatic bone fracture with clinically significant dislocation or nerve impairment is generally an indication for surgical reduction. Since few reports have documented exacerbation of visual acuity after open reduction and fixation, operation should not be delayed in patients with no systemic problems. Consideration of optic functions and consultation with related departments are essential when treating patients with mid-facial fractures.

収録刊行物

  • 日本口腔外科学会雑誌

    日本口腔外科学会雑誌 57(2), 70-73, 2011-02-20

    社団法人 日本口腔外科学会

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各種コード

  • NII論文ID(NAID)
    10030271514
  • NII書誌ID(NCID)
    AN00189163
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    00215163
  • NDL 記事登録ID
    11016629
  • NDL 雑誌分類
    ZS44(科学技術--医学--歯科学・口腔外科学)
  • NDL 請求記号
    Z19-145
  • データ提供元
    CJP書誌  NDL  J-STAGE 
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