# How I do it: Optic nerve decompression in patient with osteopetrosis

## TL;DR

This paper describes a surgical technique for optic nerve decompression in a patient with osteopetrosis to prevent vision loss.

## Contribution

A novel surgical approach combining extradural and intradural optic nerve decompression is presented for osteopetrosis patients.

## Key findings

- Intradural optic nerve identification facilitated safe decompression near the anterior clinoid process.
- Precise surgical technique and anatomical awareness minimized complications in osteopetrosis treatment.
- Optic nerve decompression can effectively preserve vision in patients with optic canal stenosis due to osteopetrosis.

## Abstract

Osteopetrosis is a rare genetic disorder causing excessive skeletal density, with a predilection to affect the skull base. This commonly leads to optic canal stenosis, optic nerve compression, and atrophy and vision loss. Timely optic nerve decompression can be an effective surgical intervention to preserve vision.

Pterional approach combining both extra- and intradural optic nerve decompression was performed. Intradural optic nerve identification proved a helpful and safe way to facilitate adequate decompression while dissecting in the region of hypertrophic anterior clinoid process.

Precise surgical technique and anatomical awareness are crucial for minimizing complications and aiding recovery.

The online version contains supplementary material available at 10.1007/s00701-025-06513-8.