Abstract:Objective To explore the identification of optic canal and decompression of optic nerve for injury prevention of important structures, and to introduce the emergency treatment of arterial hemorrhage during endoscopic optic nerve decompression. Methods 30 patients diagnosed as having traumatic optic neuropathy were included. The anatomical positions of optic nerve, carotid artery, ophthalmic artery and the extent of injury were confirmed radiologically before operation. The optic nerve decompression was performed by either direct opening of the optic canal or gradual opening of the canal along the orbital apex backward. Special attention was paid to protect the adjacent anatomical structures. Results The optic nerve and optic canal were located accurately in all the 30 cases. Among them, the optic nerve decompression was completed successfully in 28 cases. The decompression was terminated due to hemorrhage of ophthalmic artery pseudoaneurysm and timely hemostasis treatment with packs was performed in 2 cases. No serious surgical complications ocurred, such as injury of the optic nerve, internal carotid artery, ophthalmic artery, and cavernous sinus. Conclusion Choice of the suitable way to decompress the optic nerve, proper protection of important structures on the lateral wall of sphenoid sinus and adequate preparation for emergency treatment of arterial hemorrhage are essential for the endoscopic optic nerve decompression. 