Minimally invasive endoscopic-guided optic nerve canal decompression surgery Mr. Zhang, a 50-year-old native of Zhejiang Province, suffered a tragic accident a few days ago that not only left him briefly unconscious, but even more tragically, when he woke up, he found that his right eye vision was black. Mr. Zhang and his family were anxious about the loss of sight in one eye just after he had passed the age of majority. After a comprehensive analysis of his physical condition, doctors believed that the sudden blindness was related to the crash, and that there was probably a small fracture in the skull compressing the optic nerve. However, due to the limited medical level of the local hospital, there was nothing that could be done about this lesion located deep in the base of the skull. Time was ticking away, and Mr. Zhang was about to lose his last chance to regain his sight. Three-dimensional reconstruction CT scan uncovered the culprit To find the exact cause of the blindness, Professor Lou Meiqing of the Tenth Hospital performed a thin-layer CT scan of Mr. Zhang’s skull and made a three-dimensional reconstruction, which could reveal subtle fracture lines that are difficult to find in ordinary flat images and determine the specific site of the fracture. After meticulous CT 3D reconstruction, the team led by Professor Lou finally found a tiny fracture line located at the base of the skull and finally uncovered the culprit behind Mr. Zhang’s blindness – a very small fracture fragment. Once the crux of the problem was found, the treatment had a direction. The only way to restore Mr. Zhang’s sight was to surgically remove the broken bone fragment that was compressing the optic nerve. The most secure method for doctors is to perform a craniotomy to directly expose the fracture site and remove the fragment. However, for Mr. Zhang, who just recovered from a huge trauma brought about by the car accident, the damage of craniotomy is obviously unbearable, and the surgery may even make the injury worse. Is there another way? Professor Lou carefully studied the patient’s CT film and boldly proposed the option of endoscopic optic nerve canal decompression via the nasal butterfly approach. The reasons are: first, the fragmented bone is close to the midline, which provides the possibility of transnasal butterfly endoscopic access; second, this surgical access utilizes the existing physiological channels, which causes little additional damage to the patient and results in quick recovery; third, neuroendoscopic technology has become an increasingly popular technique in neurosurgery recently, and Prof. Lou’s team has many years of clinical experience and is able to perform skilled surgical operations using endoscopy, and the success rate of saving the patient with this method is very high. The success rate of patients treated with this method is very high. After a thorough demonstration, Prof. Lou led the team to perform the surgery on the patient. During the operation, Professor Lou used the neuronavigation to guide the patient, and with his knowledge of intracranial anatomy, he quickly found the fragmented bone that was compressing the optic nerve under the endoscope. However, the problem arose because the thickest intracranial blood vessel, the internal carotid artery, was near the fragmented bone. If the operation was not careful and this blood vessel was damaged, the patient would lose a lot of blood and even die of shock. At this point, Professor Lou’s skilled surgical technique came in handy. He skillfully used nerve hooks and strippers of various lengths and angles, and removed the blocker little by little, slowly and steadily. To prevent secondary damage, they also repaired the optic nerve canal. On the second day after the operation, the patient’s vision in the right eye regained light perception, and he could see the faces of the people around him three days after the operation, and has now been discharged from the hospital.