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Pneumosinus dilatans of the sphenoid and visual loss: when should the optic nerve be decompressed?
Child's Nervous System ( IF 1.4 ) Pub Date : 2020-11-03 , DOI: 10.1007/s00381-020-04916-9
Gilles Danassegarane 1 , Maxime Bretonnier 1 , Julien Tinois 1 , Maïa Proisy 2 , Laurent Riffaud 1, 3
Affiliation  

Pneumosinus dilatans of the sphenoid sinus is a rare disorder which can be responsible for visual impairment and blindness. We present the case of an adolescent female who experienced progressive decrease in right-eye vision over 2 years. CT scan of the head showed an extensive pneumatization of the sphenoid bone extending to the lesser wing of the sphenoid and to the anterior clinoid process on the right side. MRI revealed right nerve atrophy in the optic canal and in the posterior part of the orbit. A surgical decompression of the right optic canal was performed via an intradural fronto-pterional approach. Postoperatively, her vision worsened, and at 3 years the patient was able to count fingers at 2.5 m. Our case and literature review of symptomatic sphenoidal pneumosinus dilatans confirmed that visual prognosis in such cases depended on the preoperative visual status. Early surgical decompression should be proposed whenever possible, before signs of severe visual disorders and optic atrophy.



中文翻译:

蝶骨扩张性肺气肿和视力丧失:视神经何时应减压?

蝶窦扩张性肺气肿是一种罕见的疾病,可导致视力障碍和失明。我们介绍了一名青春期女性的案例,她的右眼视力在 2 年内逐渐下降。头部 CT 扫描显示蝶骨广泛气化,延伸至蝶骨小翼和右侧前床突。MRI 显示右侧视神经管和眼眶后部神经萎缩。通过硬膜内额-翼点入路对右侧视神经管进行手术减压。术后,她的视力恶化,3 岁时,患者能够在 2.5 m 处数手指。我们对症状性蝶窦扩张症的病例和文献回顾证实,此类病例的视力预后取决于术前视力状态。应尽可能在出现严重视力障碍和视神经萎缩之前尽早手术减压。

更新日期:2020-11-03
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