通过内窥镜经眼眶入路 (endoscopic transorbital approach, ETOA) 和眼眶前蝶突切除术 (transorbital anterior clinoidectomy)，可为到达眼眶的上外区，进行视神经管减压。然而，目前缺乏关于这些手术技术细节和手术结果的文献描述。本研究旨在分析经内窥镜眼眶入路结合前蝶突切除术减压视神经管对压迫性视神经病变的可行性和疗效通用过程。自2016年至2022年，我们对14名患有压迫性视神经病变的患者进行了ETOA。所有患者均接受了手术定义的“眼窝内蝶突三角”，该三角由上眶裂顶、视神经管的内侧缘、上眶裂的内侧边缘和蝶骨组成。回顾性分析了人口统计学资料、肿瘤特征、术前和术后影像学、术前和术后视力检查以及手术结果。ETOA的平均年龄为53.3岁 (范围41-64岁)，平均随访时间为16.8个月 (范围6.7-51.4个月)。本研究的纳入标准是患有脑膜瘤的患者 (14例)。在术前视力功能检查中，7例脑膜瘤患者显示出进行性视力下降。经内窥镜眼眶入路视神经管减压后，5例患者的视力功能有所改善，8例患者的视力功能保持不变，1例患者的视力功能恶化。与ETOA和前蝶突切除术相关的新发神经功能障碍在所有患者中没有发生。经内窥镜眼眶入路结合硬脑膜外前蝶突切除术是一种安全可行的技术，可避免对蝶骨内颈动脉和周围神经血管结构的重要损伤。

The endoscopic transorbital approach (ETOA) and transorbital anterior clinoidectomy have been suggested as novel procedures through which to reach the superolateral compartments of the orbit, allowing optic canal decompression. However, there is limited literature describing the technical details and surgical outcomes of these procedures. In this study, the authors aimed to analyze the feasibility and efficacy of endoscopic transorbital decompression of the optic canal through anterior clinoidectomy for compressive optic neuropathic lesions.Between 2016 and 2022, the authors performed ETOA for compressive optic neuropathic lesions in 14 patients. All these patients underwent transorbital anterior clinoidectomy through the surgically defined "intraorbital clinoidal triangle," which is composed of the roof of the superior orbital fissure, the medial margin of the optic canal, the medial border of the superior orbital fissure, and the optic strut. Demographic data, tumor characteristics, pre- and postoperative imaging, pre- and postoperative visual examinations, and surgical outcomes were retrospectively reviewed.The mean age at the time of ETOA was 53.3 years (range 41-64 years), and the mean follow-up was 16.8 months (range 6.7-51.4 months). The inclusion criterion in this study was having a meningioma (14 patients). In the preoperative visual function examination, 7 patients with a meningioma showed progressive visual impairment. After endoscopic transorbital optic canal decompression, visual function improved in 5 patients, remained unchanged in 8 patients, and worsened in 1 patient. No new-onset neurological deficit was associated with ETOA and anterior clinoidectomy in any patients.Endoscopic transorbital decompression of the optic canal with extradural anterior clinoidectomy is a safe and feasible technique that avoids significant injury to the clinoidal internal carotid artery and surrounding neurovascular structures.