To investigate the therapeutic effect and prognostic factors of optic nerve decompression via ethmoid sphenoid approach in traumatic optic neuropathy (TON).

A total of 49 patients with TON in Neurosurgery Department of Tianjin Medical University General Hospital from January 2008 to December 2019 were retrospectively analyzed. Based on the postoperative visual acuity recovery and related complications, the clinical efficacy of ethmoid sphenoidal approach for optic nerve decompression was evaluated, and the factors affecting the prognosis were analyzed.

All 49 patients were treated with the decompression of optic nerve tube through sieve butterfly approach, and there’s no serious complications after surgery. The total effective rate was 53.1%. Through single factor analysis, it was found that optical preoperative visual response, trauma to surgical interval are closely related to postoperative vision improvement (P=0.011, 0.016). The age, consciousness, degree of optic nerve canal fracture, different surgical approaches and CSF leakage were not significantly correlated with prognosis.

The visual acuity of patients with TON can be improved by optic nerve decompression through ethmoid sphenoidal approach, and the patients with preoperative light perception and early post-trauma surgery may obtain better treatment effect after operation.