目的 探索颅面骨纤维结构不良所致的视神经管狭窄的手术治疗策略。方法 回顾性分析2012年8月至2017年9月收治的18例颅面骨纤维结构不良所致的视神经管狭窄的手术病例,总结分析其临床表现、影像学表现、手术方法和结果。结果 7例患者接受治疗性视神经管减压,5例患者接受预防性视神经管减压,6例患者单纯接受骨纤切除整复。随访结果显示,12例行视神经管减压手术患者中,3例视力改善,7例保持稳定,2例视力恶化。结论 对于颅面骨纤维结构不良导致的视神经管狭窄、视力障碍,视神经管减压手术能有效终止视力恶化趋势,并有改善视力的可能。使用神经导航技术进行术前设计与术中辅助,可有效提高手术效率及安全性,降低视神经损伤、视力恶化风险。

Objective To explore the surgical treatment strategy for optic canal stenosis caused by craniofacial fibrous dysplasia.Methods A retrospective analysis was made reviewing the 18 cases from August 2012 to September 2017.The clinical and imaging findings and the discussion of the operative methods and results were summarized.Results Seven patients were treated with optic nerve decompression,five patients received prophylactic decompression,and six patients received fibrous dysplasia resection.At the end of follow-up,among patients who received optic nerve decompression,3 patients achieved visual improvement,7 maintained previous vision and 2 had decreased visual acuity.Conclusion Optic nerve decompression can effectively terminate the trend of visual deterioration and possibly improve visual acuity for patients suffered from optic canal stenosis caused by craniofacial fibrous dysplasia.Neuronavigation can effectively improve the efficiency and safety of operation,and reduce the risk of optic nerve injury and visual deterioration.