====== Transethmoidal decompression ======

see [[Transethmoidal approach]].

Over a period of ten years, 39 [[patient]]s who had suffered [[optic nerve]] [[compression]] after a [[craniocerebral]] [[trauma]] underwent [[transethmoidal]] [[decompression]] [[surgery]]. The [[operation]] was performed bilaterally on 5 patients. Fifty percent of patients involved suffered a [[blunt]] [[head]] or [[brain injury]], the others [[brain]] [[compression]] or [[contusion]]. On the side of [[optic nerve compression]], Kolenda et al. from the Neurosurgical Department, University of [[Göttingen]], [[Germany]], found specific [[sign]]s and [[symptom]]s of the [[compression]] such as negative or [[sluggish]] [[direct light reflex]] of the [[pupil]], [[wound]]s on the lateral side of the [[eyebrow]], bleeding from the [[nose]], [[eyelid]] [[hematoma]], [[skull fracture]]s and [[intracranial hematoma]]s. Since radiological and [[intraoperative]] findings were the same in only 67% of cases ophthalmological findings such as lack of direct [[pupillary response]] occurring together with preserved [[consensual response]] and progressive [[loss of vision]] after a traumatic incident are used as [[guideline]] for performing transethmoidal decompression of the [[optic nerve]]. Surgery produced restitution of visual function in about 10% more cases than conservative therapy reported in the literature
((Kolenda H, Schröder M, Mühlendyck H, Rama B, Markakis E. Transethmoidal
decompression of the optic nerve in the case of craniocerebral trauma. Neurosurg 
Rev. 1988;11(1):39-43. PubMed PMID: 3217018.
)).