[Traumatic Rollel's syndrome treated with decompression of orbital apex].

OBJECTIVE

To observe the efficiency of decompression of orbital apex operation for the treatment of traumatic Rollel's syndrome.

METHODS

Eleven patients with Rollel's syndrome were operated using two different approaches of decompression of orbital apex according to the location of the lesion. Five cases were treated by trans-frontal approach and 6 cases by trans-pterion approach. For the purpose of evaluation, the postoperative outcome of visual acuity was classified into five grades: Non-light perception, light perception, hand motion, finger counter and acuity chart. The visual acuity improvement reaching 1 grade or more was defined as effective and less than 1 grade as inefficient. The improvement of nerve injuries in superior orbital fissure was also evaluated, patients with recover of 2 or more nerves was defined as effective.

RESULTS

Visual acuity: 3 cases (50%) were classified as effective in non-light perception group, the remaining 5 cases who had residual vision before operation all improved to various extents. The eye position in cases with exophthalmos was return to normal after operation. Injured nerves were recovered in all 11 cases.

CONCLUSIONS

Decompression of orbital apex is an effective treatment for patients with Rollel's syndrome and the craniotomy approach can treat the combined brain injury. The recovery after operation is correlated with the timing of surgery, the approach of the operation and also related with the severity of the nerve injury.