AIM:To explore the therapeutic effects of microsurgical decompression of traumatic optic nerve neuropathy via transcranial approach,in comparison of extracranial approach.METHODS:A total of 12 cases with optic nerve neuropathy which underwent microsurgical decompression via transcranial approach were retrospectively analyzed,and the clinical characteristics and methods of the therapy were concluded.The recent literatures on surgical decompression of optic nerve neuropathy via extracranial approach were reviewed and the therapeutic effects of such an extracranial approach were compared with our transcranial approach.RESULTS:All patients were followed up for 3 to 12 months postoperatively,with an average rate of efficacy being 83 percent.No patient experienced cerebrospinal fluid leakage after surgery.CONCLUSION:The efficacy of decompression of optic nerve neuropathy through the optic canal is concluded and the surgery should be performed as early as possible.Because of the better therapeutic effects,decompression of optic nerve neuropathy via transcranial approach is superior to that via extracranial approach.