Skip to main content
Log in

An evolving perspective of endoscopic transnasal optic canal decompression for traumatic optic neuropathy in clinic

  • Review
  • Published:
Neurosurgical Review Aims and scope Submit manuscript

Abstract

Traumatic optic neuropathy (TON) is a serious complication of craniofacial trauma, which damages the optic nerve indirectly and leads to dysfunction of visual acuity. The clinical intervention for a patient with TON includes optic canal decompression (with or without steroids), treatment with corticosteroids alone, or observation only. Currently, there is a controversy among clinicians as to which treatment is optimal. An increasing number of retrospective studies have unveiled that patients could experience significant improvement in visual acuity after optic canal decompression surgery, particularly endoscopic transnasal/transethmosphenoid optic canal decompression (ETOCD), either with or without corticosteroids. In this review, we discuss the evolving perspective on surgical treatment, specifically ETOCD, for the management of patients with TON and focus mainly on the therapeutic efficacy, safety, and resulting prognosis in the clinic.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Steinsapir KD, Goldberg RA (1994) Traumatic optic neuropathy. Surv Ophthalmol 38(6):487–518

    Article  CAS  PubMed  Google Scholar 

  2. Sarkies N (2004) Traumatic optic neuropathy. Eye (Lond) 18(11):1122–1125

    Article  CAS  Google Scholar 

  3. Guy WM, Soparkar CN, Alford EL, Patrinely JR, Sami MS, Parke RB (2014) Traumatic optic neuropathy and second optic nerve injuries. JAMA Ophthalmol 132(5):567–571

    Article  PubMed  Google Scholar 

  4. Kline LB, Morawetz RB, Swaid SN (1984) Indirect injury of the optic nerve. Neurosurgery 14(6):756–764

    Article  CAS  PubMed  Google Scholar 

  5. Lee V, Ford RL, Xing W, Bunce C, Foot B (2010) Surveillance of traumatic optic neuropathy in the UK. Eye (Lond) 24(2):240–250

    Article  CAS  Google Scholar 

  6. Yu-Wai-Man P, Griffiths PG (2013) Surgery for traumatic optic neuropathy. Cochrane Database Syst Rev 6:CD005024

    PubMed  Google Scholar 

  7. Yu-Wai-Man P, Griffiths PG (2013) Steroids for traumatic optic neuropathy. Cochrane Database Syst Rev 6:CD006032

    Google Scholar 

  8. Cook MW, Levin LA, Joseph MP, Pinczower EF (1996) Traumatic optic neuropathy. A meta-analysis. Arch Otolaryngol Head Neck Surg 122(4):389–392

    Article  CAS  PubMed  Google Scholar 

  9. Levin LA, Beck RW, Joseph MP, Seiff S, Kraker R (1999) The treatment of traumatic optic neuropathy: the international optic nerve trauma study. Ophthalmology 106(7):1268–1277

    Article  CAS  PubMed  Google Scholar 

  10. Chaon BC, Lee MS (2015) Is there treatment for traumatic optic neuropathy? Curr Opin Ophthalmol 26(6):445–449

    Article  PubMed  Google Scholar 

  11. Abhinav K, Acosta Y, Wang WH et al (2015) Endoscopic endonasal approach to the optic canal: anatomic considerations and surgical relevance. Neurosurgery 11(Suppl 3):431–445

    PubMed  Google Scholar 

  12. Berhouma M, Jacquesson T, Abouaf L, Vighetto A, Jouanneau E (2014) Endoscopic endonasal optic nerve and orbital apex decompression for nontraumatic optic neuropathy: surgical nuances and review of the literature. Neurosurg Focus 37(4):E19

    Article  PubMed  Google Scholar 

  13. Di Somma A, Cavallo LM, de Notaris M et al (2017) Endoscopic endonasal medial-to-lateral and trans orbital lateral-to-medial optic nerve decompression: an anatomical study with surgical implications. J Neurosurg 127(1):199–208

    Article  PubMed  Google Scholar 

  14. Kong DS, Shin HJ, Kim HY, Chung SK, Nam DH, Lee JI, Park K, Kim JH (2011) Endoscopic optic canal decompression for compressive optic neuropathy. J Clin Neurosci 18(11):1541–1545

    Article  PubMed  Google Scholar 

  15. Chen C, Selva D, Floreani S, Wormald PJ (2006) Endoscopic optic nerve decompression for traumatic optic neuropathy: an alternative. Otolaryngol Head Neck Surg 135(1):155–157

    Article  PubMed  Google Scholar 

  16. Chen M, Jiang Y, Zhang J, Li N (2018) Clinical treatment of traumatic optic neuropathy in children: summary of 29 cases. Exp Ther Med 16(4):3562–3566

    PubMed  PubMed Central  Google Scholar 

  17. Ropposch T, Steger B, Meço C, Emesz M, Reitsamer H, Rasp G, Moser G (2013) The effect of steroids in combination with optic nerve decompression surgery in traumatic optic neuropathy. Laryngoscope 123(5):1082–1086

    Article  CAS  PubMed  Google Scholar 

  18. Xie D, Yu H, Ju J, Zhang L (2017) The outcome of endoscopic optic nerve decompression for bilateral traumatic optic neuropathy. J Craniofac Surg 28(4):1024–1026

    Article  PubMed  Google Scholar 

  19. Horiguchi K, Murai H, Hasegawa Y, Mine S, Yamakami I, Saeki N (2010) Endoscopic endonasal trans-sphenoidal optic nerve decompression for traumatic optic neuropathy--technical note. Neurol Med Chir (Tokyo) 50(6):518–522

    Article  Google Scholar 

  20. Wang DH, Zheng CQ, Qian J, Barr JJ, Anderson AG Jr (2008) Endoscopic optic nerve decompression for the treatment of traumatic optic nerve neuropathy. ORL J Otorhinolaryngol Relat Spec 70(2):130–133

    Article  PubMed  Google Scholar 

  21. Jiang RS, Hsu CY, Shen BH (2001) Endoscopic optic nerve decompression for the treatment of traumatic optic neuropathy. Rhinology 39(2):71–74

    CAS  PubMed  Google Scholar 

  22. Kountakis SE, Maillard AAJ, Urso R, Stiernberg CM (1997) Endoscopic approach to traumatic visual loss. Otolaryngol Head Neck Surg 116(6):652–655

    Article  CAS  PubMed  Google Scholar 

  23. Ma YJ, Yu B, Tu YH, Mao BX, Yu XY, Wu WC (2018) Prognostic factors of trans-ethmosphenoid optic canal decompression for indirect traumatic optic neuropathy. Int J Ophthalmol 11(7):1222–1226

    PubMed  PubMed Central  Google Scholar 

  24. Yu B, Ma Y, Tu Y, Wu W (2016) The outcome of endoscopic transethmosphenoid optic canal decompression for indirect traumatic optic neuropathy with no-light-perception. J Ophthalmol 2016:6492858

    PubMed  PubMed Central  Google Scholar 

  25. Yan W, Chen Y, Qian Z, Selva D, Pelaez D, Tu Y, Wu W (2017) Incidence of optic canal fracture in the traumatic optic neuropathy and its effect on the visual outcome. Br J Ophthalmol 101(3):261–267

    PubMed  Google Scholar 

  26. Thaker A, Tandon DA, Mahapatra AK (2009) Surgery for optic nerve injury: should nerve sheath incision supplement osseous decompression? Skull Base 19(4):263–271

    Article  PubMed  PubMed Central  Google Scholar 

  27. Xu R, Chen F, Zuo K, Ye X, Yang Q, Shi J, Chen H, Li H (2014) Endoscopic optic nerve decompression for patients with traumatic optic neuropathy: is nerve sheath incision necessary? ORL J Otorhinolaryngol Relat Spec 76(1):44–49

    Article  PubMed  Google Scholar 

  28. Song Y, Li H, Ma Y, Li W, Zhang X, Pan X, Tan G (2013) Analysis of prognostic factors of endoscopic optic nerve decompression in traumatic blindness. Acta Otolaryngol 133(11):1196–1200

    Article  PubMed  Google Scholar 

  29. Gupta D, Gadodia M (2018) Transnasal endoscopic optic nerve decompression in posttraumatic optic neuropathy. Indian J Otolaryngol Head Neck Surg 70(1):49–52

    Article  PubMed  Google Scholar 

  30. Li HB, Shi JB, Cheng L, Yun O, Xu G (2007) Salvage optic nerve decompression for traumatic blindness under nasal endoscopy: risk and benefit analysis. Clin Otolaryngol 32(6):447–451

    Article  CAS  PubMed  Google Scholar 

  31. Kountakis SE, Maillard AA, El-Harazi SM, Longhini L, Urso RG (2000) Endoscopic optic nerve decompression for traumatic blindness. Otolaryngol Head Neck Surg 123(1 Pt 1):34–37

    Article  CAS  PubMed  Google Scholar 

  32. Emanuelli E, Bignami M, Digilio E, Fusetti S, Volo T, Castelnuovo P (2015) Post-traumatic optic neuropathy: our surgical and medical protocol. Eur Arch Otorhinolaryngol 272(11):3301–3309

    Article  CAS  PubMed  Google Scholar 

  33. Peng A, Li Y, Hu P, Wang Q (2011) Endoscopic optic nerve decompression for traumatic optic neuropathy in children. Int J Pediatr Otorhinolaryngol 75(8):992–998

    Article  PubMed  Google Scholar 

  34. Gupta AK, Gupta AK, Gupta A, Malhotra SK (2007) Traumatic optic neuropathy in pediatric population: early intervention or delayed intervention? Int J Pediatr Otorhinolaryngol 71(4):559–562

    Article  PubMed  Google Scholar 

  35. Yu B, Chen Y, Ma Y, Tu Y, Wu W (2018) Outcome of endoscopic trans-ethmosphenoid optic canal decompression for indirect traumatic optic neuropathy in children. BMC Ophthalmol 18(1):152

    Article  PubMed  PubMed Central  Google Scholar 

  36. Li H, Zhou B, Shi J, Cheng L, Wen W, Xu G (2008) Treatment of traumatic optic neuropathy: our experience of endoscopic optic nerve decompression. J Laryngol Otol 122(12):1325–1329

    Article  CAS  PubMed  Google Scholar 

  37. Yang WG, Chen CT, Tsay PK, de Villa GH, Tsai YJ, Chen YR (2004) Outcome for traumatic optic neuropathy--surgical versus nonsurgical treatment. Ann Plast Surg 52(1):36–42

    Article  PubMed  Google Scholar 

  38. Rajiniganth MG, Gupta AK, Gupta A, Bapuraj JR (2003) Traumatic optic neuropathy: visual outcome following combined therapy protocol. Arch Otolaryngol Head Neck Surg 129(11):1203–1206

    Article  CAS  PubMed  Google Scholar 

  39. Dhaliwal SS, Sowerby LJ, Rotenberg BW (2016) Timing of endoscopic surgical decompression in traumatic optic neuropathy: a systematic review of the literature. Int Forum Allergy Rhinol 6(6):661–667

    Article  PubMed  Google Scholar 

  40. Chen F, Zuo K, Feng S, Guo J, Fan Y, Shi J, Li H (2014) A modified surgical procedure for endoscopic optic nerve decompression for the treatment of traumatic optic neuropathy. N Am J Med Sci 6(6):270–273

    PubMed  PubMed Central  Google Scholar 

  41. De Ganseman A, Lasudry J, Choufani G, Daele J, Hassid S (2000) Intranasal endoscopic surgery in traumatic optic neuropathy--the Belgian experience. Acta Otorhinolaryngol Belg 54(2):175–177

    PubMed  Google Scholar 

  42. Steinsapir KD, Goldberg RA (2011) Traumatic optic neuropathy: an evolving understanding. Am J Ophthalmol 151(6):928–933.e2

    Article  PubMed  Google Scholar 

  43. Erdogmus S, Govsa F (2006) Anatomic features of the intracranial and intracanalicular portions of ophthalmic artery: for the surgical procedures. Neurosurg Rev 29(3):213–218

    Article  PubMed  Google Scholar 

  44. Locatelli M, Caroli M, Pluderi M, Motta F, Gaini SM, Tschabitscher M, Scarone P (2011) Endoscopic transsphenoidal optic nerve decompression: an anatomical study. Surg Radiol Anat 33(3):257–262

    Article  PubMed  Google Scholar 

  45. Asal N, Bayar Muluk N, Inal M, Şahan MH, Doğan A, Arıkan OK (2019) Carotid canal and optic canal at sphenoid sinus. Neurosurg Rev 42(2):519–529

    Article  PubMed  Google Scholar 

  46. Özdemir A, Bayar Muluk N, Asal N, Şahan MH, Inal M (2019) Is there a relationship between Onodi cell and optic canal? Eur Arch Otorhinolaryngol 276(4):1057–1064

    Article  PubMed  Google Scholar 

  47. Walsh FB (1966) Pathological-clinical correlations. I. Indirect trauma to the optic nerves and chiasm. II. Certain cerebral involvements associated with defective blood supply. Invest Ophthalmol 5(5):433–449

    CAS  PubMed  Google Scholar 

  48. McClenaghan FC, Ezra DG, Holmes SB (2011) Mechanisms and management of vision loss following orbital and facial trauma. Curr Opin Ophthalmol 22(5):426–431

    Article  CAS  PubMed  Google Scholar 

  49. Morgan-Warren PJ, Berry M, Ahmed Z, Scott RA, Logan A (2013) Exploiting mTOR signaling: a novel translatable treatment strategy for traumatic optic neuropathy? Invest Ophthalmol Vis Sci 54(10):6903–6916

    Article  CAS  PubMed  Google Scholar 

  50. Cirovic S, Bhola RM, Hose DR, Howard IC, Lawford PV, Marr JE, Parsons MA (2006) Computer modelling study of the mechanism of optic nerve injury in blunt trauma. Br J Ophthalmol 90(6):778–783

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Lecler A, Savatovsky J, Cahuzac A (2018) Traumatic optic nerve transection. JAMA Ophthalmol 136(5):e180490

    Article  PubMed  Google Scholar 

  52. Paya C, Delyfer MN, Thoumazet F, Pechemeja J, Bocquet J, Korobelnik JF, Colin J, Mortemousque B (2012) Traumatic optic nerve avulsion: a case report. J Fr Ophtalmol 35(5):360–e1-4

    Article  PubMed  Google Scholar 

  53. Simsek T, Simsek E, Ilhan B, Ozalp S, Sekercioglu B, Zilelioglu O (2006) Traumatic optic nerve avulsion. J Pediatr Ophthalmol Strabismus 43(6):367–369

    Article  PubMed  Google Scholar 

  54. Warner N, Eggenberger E (2010) Traumatic optic neuropathy: a review of the current literature. Curr Opin Ophthalmol 21(6):459–462

    Article  PubMed  Google Scholar 

  55. Yu-Wai-Man P (2015) Traumatic optic neuropathy-clinical features and management issues. Taiwan J Ophthalmol 5(1):3–8

    Article  PubMed  PubMed Central  Google Scholar 

  56. Bodanapally UK, Van der Byl G, Shanmuganathan K et al (2014) Traumatic optic neuropathy prediction after blunt facial trauma: derivation of a risk score based on facial CT findings at admission. Radiology 272(3):824–831

    Article  PubMed  Google Scholar 

  57. Hart CK, Theodosopoulos PV, Zimmer LA (2009) Anatomy of the optic canal: a computed tomography study of endoscopic nerve decompression. Ann Otol Rhinol Laryngol 118(12):839–844

    Article  PubMed  Google Scholar 

  58. Zhao Y, Duan H, Liu J, Cheng K, Han Y, Li Y (2017) Three-dimensional radiologic study on index measurement of endonasal endoscopic optic nerve decompression. J Craniofac Surg 28(6):1598–1602

    Article  PubMed  Google Scholar 

  59. Kang Z, Li J, Zou Y, Yang Q (2013) Diagnosis and treatment of traumatic optic neuropathy with carotid artery cavernous segment pseudoaneurysm. Laryngoscope 123(11):2591–2597

    Article  PubMed  Google Scholar 

  60. Zimmerer R, Rana M, Schumann P, Gellrich NC (2014) Diagnosis and treatment of optic nerve trauma. Facial Plast Surg 30(5):518–527

    Article  CAS  PubMed  Google Scholar 

  61. Kim JW, Andersson JL, Seifert AC, Sun P, Song SK, Dula C, Naismith RT, Xu J (2019) Incorporating non-linear alignment and multi-compartmental modeling for improved human optic nerve diffusion imaging. Neuroimage 196:102–113

    Article  PubMed  Google Scholar 

  62. Yang QT, Fan YP, Zou Y, Kang Z, Hu B, Liu X, Zhang GH, Li Y (2011) Evaluation of traumatic optic neuropathy in patients with optic canal fracture using diffusion tensor magnetic resonance imaging: a preliminary report. ORL J Otorhinolaryngol Relat Spec 73(6):301–307

    Article  PubMed  Google Scholar 

  63. Bodanapally UK, Kathirkamanathan S, Geraymovych E, Mirvis SE, Choi AY, McMillan A, Zhuo J, Shin RK (2013) Diagnosis of traumatic optic neuropathy: application of diffusion tensor magnetic resonance imaging. J Neuroophthalmol 33(2):128–133

    Article  PubMed  Google Scholar 

  64. Al-Zubidi N, Ansari W, Fung SH, Lee AG (2014) Diffusion tensor imaging in traumatic optic tract syndrome. J Neuroophthalmol 34(1):95–98

    Article  PubMed  Google Scholar 

  65. Bodanapally UK, Shanmuganathan K, Shin RK, Dreizin D, Katzman L, Reddy RP, Mascarenhas D (2015) Hyperintense optic nerve due to diffusion restriction: diffusion-weighted imaging in traumatic optic neuropathy. AJNR Am J Neuroradiol 36(8):1536–1541

    Article  CAS  PubMed  Google Scholar 

  66. Mine S, Yamakami I, Yamaura A, Hanawa K, Ikejiri M, Mizota A, Adachi-Usami E Outcome of traumatic optic neuropathy. Comparison between surgical and nonsurgical treatment. Acta Neurochir (Wien) 1999;141(1):27-30

  67. Yang Y, Wang H, Shao Y, Wei Z, Zhu S, Wang J (2006) Extradural anterior clinoidectomy as an alternative approach for optic nerve decompression: anatomic study and clinical experience. Neurosurgery 59(4 Suppl 2):ONS253–ONS262 discussion ONS262

    PubMed  Google Scholar 

  68. Zhilin G, Huoniu O, Zhihua C, Guorong D (2011) Wide optic nerve canal decompression for the treatment of blindness resulting from an indirect optic nerve injury. J Craniofac Surg 22(4):1463–1465

    Article  PubMed  Google Scholar 

  69. He Z, Li Q, Yuan J, Zhang X, Gao R, Han Y, Yang W, Shi X, Lan Z (2015) Evaluation of transcranial surgical decompression of the optic canal as a treatment option for traumatic optic neuropathy. Clin Neurol Neurosurg 134:130–135

    Article  PubMed  Google Scholar 

  70. Lübben B, Stoll W, Grenzebach U (2001) Optic nerve decompression in the comatose and conscious patients after trauma. Laryngoscope 111(2):320–328

    Article  PubMed  Google Scholar 

  71. Otani N, Wada K, Fujii K, Toyooka T, Kumagai K, Ueno H, Tomura S, Tomiyama A, Nakao Y, Yamamoto T, Mori K (2016) Usefulness of extradural optic nerve decompression via trans-superior orbital fissure approach for treatment of traumatic optic nerve injury: surgical procedures and techniques from experience with 8 consecutive patients. World Neurosurg 90:357–363

    Article  PubMed  Google Scholar 

  72. Joseph MP, Lessell S, Rizzo J, Momose KJ (1990) Extracranial optic nerve decompression for traumatic optic neuropathy. Arch Ophthalmol 108(8):1091–1093

    Article  CAS  PubMed  Google Scholar 

  73. Levin LA, Joseph MP, Rizzo JF 3rd (1994) Lessell S. Optic canal decompression in indirect optic nerve trauma. Ophthalmology 101(3):566–569

    Article  CAS  PubMed  Google Scholar 

  74. Li KK, Teknos TN, Lai A, Lauretano AM, Joseph MP (1999) Traumatic optic neuropathy: result in 45 consecutive surgically treated patients. Otolaryngol Head Neck Surg 120(1):5–11

    Article  CAS  PubMed  Google Scholar 

  75. Li KK, Teknos TN, Lai A, Lauretano A, Terrell J, Joseph MP (1999) Extracranial optic nerve decompression: a 10-year review of 92 patients. J Craniofac Surg 10(5):454–459

    Article  CAS  PubMed  Google Scholar 

  76. Thakar A, Mahapatra AK, Tandon DA (2003) Delayed optic nerve decompression for indirect optic nerve injury. Laryngoscope 113(1):112–119

    Article  CAS  PubMed  Google Scholar 

  77. Chen CT, Huang F, Tsay PK et al (2007) Endoscopically assisted transconjunctival decompression of traumatic optic neuropathy. J Craniofac Surg 18(1):19–26 discussion 27-8

    Article  CAS  PubMed  Google Scholar 

  78. Lai IL, Liao HT (2018) Risk factor analysis for the outcomes of indirect traumatic optic neuropathy with no light perception at initial visual acuity testing. World Neurosurg 115:e620–e628

    Article  PubMed  Google Scholar 

  79. Medeiros FA, Moura FC, Vessani RM, Susanna R Jr (2003) Axonal loss after traumatic optic neuropathy documented by optical coherence tomography. Am J Ophthalmol 135(3):406–408

    Article  PubMed  Google Scholar 

  80. Ustymowicz A, Mariak Z, Obuchowska I, Mariak Z, Kochanowicz J (2009) Blood flow disturbances in the central retinal artery in patients with traumatic optic neuropathy. Med Sci Monit 15(7):CR366–CR371

    PubMed  Google Scholar 

  81. Shi W, Wang HZ, Song WX, Yang WL, Li WY, Wang NL (2013) Axonal loss and blood flow disturbances in the natural course of indirect traumatic optic neuropathy. Chin Med J (Engl) 126(7):1292–1297

    Google Scholar 

  82. Kubal WS (2008) Imaging of orbital trauma. Radiographics 28(6):1729–1739

    Article  PubMed  Google Scholar 

  83. Levin LA (1999) Intrinsic survival mechanisms for retinal ganglion cells. Eur J Ophthalmol 9(Suppl 1):S12–S16

    Article  PubMed  Google Scholar 

  84. Levin LA, Baker RS (2003) Management of traumatic optic neuropathy. J Neuroophthalmol 23(1):72–75

    Article  PubMed  Google Scholar 

  85. Mauriello JA, DeLuca J, Krieger A, Schulder M, Frohman L (1992) Management of traumatic optic neuropathy--a study of 23 patients. Br J Ophthalmol 76(6):349–352

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  86. Boyack I, McPhee D, Rose Y, Gold M (2016) Posttraumatic pneumatization of the optic sheath. Am J Emerg Med (34, 9):1911.e3–1911.e4

  87. Hui C, Xiaoyun W, Yi L, Ningbo C, Xizhong Q, Shaowei Y, Wei L, Maozhu Z, Wubo M, Xuefei P, Li L, Haibin T, Daiwen Z, Yong J (2014) Visual improvement and pain resolution in traumatic optic nerve sheath meningocele treated by optic nerve sheath fenestration. Restor Neurol Neurosci 32(5):655–661

    PubMed  Google Scholar 

  88. Acheson JF (2004) Optic nerve disorders: role of canal and nerve sheath decompression surgery. Eye (Lond) 18(11):1169–1174

    Article  CAS  Google Scholar 

  89. Gilbert AL, Chwalisz B, Mallery R (2018) Complications of optic nerve sheath fenestration as a treatment for idiopathic intracranial hypertension. Semin Ophthalmol 33(1):36–41

    Article  PubMed  Google Scholar 

Download references

Funding

This work was supported by the grants of the Major Research and Development Project of Zhejiang Province (No. 2017C03021) and Medical Health Science and Technology Project of Zhejiang Province (No. 2018ZD018).

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to Jianmin Zhang or Wei Yan.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent was not required for this type of study since it did not involve human or animal participants.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lin, J., Hu, W., Wu, Q. et al. An evolving perspective of endoscopic transnasal optic canal decompression for traumatic optic neuropathy in clinic. Neurosurg Rev 44, 19–27 (2021). https://doi.org/10.1007/s10143-019-01208-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10143-019-01208-y

Keywords

Navigation