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为了解经筛、蝶窦径路行视神经减压术对外伤性视神经损伤治疗的有效性及手术时机的选择作回顾性研究。对41例外伤性视神经损伤患者中的35例行经筛、蝶窦径路减压术，另6例应用大剂量皮质激素保守治疗。结果手术者中13例视力得到改善，保守治疗者中1例视力改善。12例治疗前有残余视力的患者，8例接受手术治疗，其中7例视力得以改善；4例接受保守治疗者，1例视力得以改善。29树治疗前无光感的患者，27例接受手术治疗，其中6例视力得以改善；2例接受保守治疗者，视力均未得到改善。结论：经筛、蝶窦径路视神经减压术可有效地改善外伤性视神经损伤的预后，如能尽早手术，手术前后应用大剂量皮质激素能够改善该病预后。伤后视力完全丧失及视觉诱发电位患侧无波并非手术绝对禁忌证。
To understand the screening, the optic canal of the sphenoid sinus optic nerve decompression of traumatic optic nerve injury treatment of the effectiveness and timing of surgery for retrospective study. Of 41 patients with traumatic optic nerve injury, 35 patients underwent sutures and sphenoidal sinus decompression, while the other 6 patients were treated with high-dose corticosteroid. Results 13 patients with surgery improved visual acuity, conservative treatment of 1 case of visual acuity improved. Twelve patients with residual visual acuity before treatment, 8 patients underwent surgery, of which 7 cases of visual acuity was improved; 4 cases of conservative treatment, 1 case of visual acuity was improved. 29 patients without light feeling before treatment, 27 patients underwent surgery, of which 6 cases of visual acuity was improved; 2 cases of conservative treatment, visual acuity were not improved. Conclusion: The optic nerve decompression through the screen and the sphenoid sinus pathways can effectively improve the prognosis of traumatic optic nerve injury. If as soon as possible surgery, high-dose corticosteroids before and after surgery can improve the prognosis. The complete loss of visual acuity after injury and visual evoked potential of the affected side is not an absolute contraindication to surgery.