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    By Kelvin K. L. Chong, MD; Clement C. Y. Tham, MBBS
    AAO 2014
    Oculoplastics/Orbit

    In this video optic canal decompression is performed using a high-speed diamond drill to create a bony window and then completed by cold-steel instruments (rongeurs) to minimize heat-related damage. A hairline canal fracture, missed in the preoperative CT scan, is noticed, and the nerve sheath is already torn underneath. The optic nerve is exposed from the apex toward the sellar floor before chiasmal entry. Surgery is finished with a free nasal mucosal graft covering the traumatic nerve sheath defect.