scholarly journals A 16-Year Study on Incidence and Progression of Diseased Sphenoethmoidal (Onodi) Cell

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Ethan I. Huang ◽  
Chia-Ling Kuo ◽  
Li-Wen Lee
Keyword(s):  
Computed Tomography ◽  
Decision Making ◽  
Optic Nerve ◽  
Endoscopic Sinus Surgery ◽  
Visual Loss ◽  
Sinus Surgery ◽  
Acute Visual Loss ◽  
Computed Tomography Images ◽  
Onodi Cell

Traumatic operative injury of the optic nerve in an endoscopic sinus surgery may cause immediate or delayed blindness. It should be cautioned when operating in a sphenoethmoidal cell, or known as Onodi cell, with contact or bulge of the optic canal. It remains unclear how frequent progression to visual loss occurs and how long it progresses to visual loss because of a diseased sphenoethmoidal cell. Research to discuss these questions is expected to help decision making to treat diseased sphenoethmoidal cells. From July 2001 to June 2017, 216 patients received conservative endoscopic sinus surgery without opening a diseased sphenoethmoidal cell. We used their computed tomography images of paranasal sinuses to identify diseased sphenoethmoidal cells that could be associated with progression to visual loss. Among the 216 patients, 52.3% had at least one sphenoethmoidal cell, and 14.8% developed at least one diseased sphenoethmoidal cell. One patient developed acute visual loss 4412 days after the first computed tomography. Our results show that over half of the patients have a sphenoethmoidal cell but suggest a rare incidence of a diseased sphenoethmoidal cell progressing to visual loss during the follow-up period.

scholarly journals The Prevalence of an Onodi Cell in Adult Thai Cadavers

2003 ◽  
Vol 82 (3) ◽  
pp. 200-204 ◽  
Author(s):  
Sanguansak Thanaviratananich ◽  
Kowit Chaisiwamongkol ◽  
Suthee Kraitrakul ◽  
Watcharachai Tangsawad
Keyword(s):  
Optic Nerve ◽  
High Risk ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Minimum Amount ◽  
Bone Thickness ◽  
Optic Nerve Injury ◽  
Nasal Endoscope ◽  
Anatomic Dissection ◽  
Onodi Cell

Endoscopic sinus surgery in patients who have an Onodi cell (sphenoethmoid cell) carries a high risk for optic nerve injury. We meticulously dissected 65 embalmed cadaver adult half-heads and attempted to identify an optic canal bulge in each with a nasal endoscope. Our aims were to determine the prevalence of an Onodi cell in adult Thai cadavers, to ascertain the prevalence of an overriding ethmoid cell, and to measure the length of an overriding ethmoid cell's superior and posterior extensions in relation to the anterior sphenoid wall. Moreover, we attempted to determine the minimum amount of bone thickness between an Onodi cell and the optic nerve. We found that an Onodi cell was present in 39 of the 65 specimens (60.0%). We also found that an overriding ethmoid cell was present in 14 specimens, which accounted for 21.5% of the total number of specimens and 36.8% of 38 Onodi cell-positive specimens (the presence or absence of an overriding ethmoid cell was not recorded in one of the 39 Onodi cell-positive specimens). The distance of the overriding ethmoid cell's superior and posterior extensions from the anterior sphenoid wall ranged from 3 to 13 mm (median: 7) and from 4 to 16 mm (median: 9.5), respectively. Measurements of the minimum amount of bone thicknesses between each Onodi cell and optic nerve ranged from 0.03 to 0.54 mm (median: 0.08). Our study demonstrated that the prevalence of an Onodi cell in adult Thai cadavers was as great as the prevalence reported in the only other gross anatomic dissection study performed in Asia and much higher than rates generally reported in Western countries.

Bony nasolacrimal duct dehiscence in functional endoscopic sinus surgery: radiological study and discussion of surgical implications

2015 ◽  
Vol 129 (S3) ◽  
pp. S35-S40 ◽  
Author(s):  
M J Ali ◽  
J Murphy ◽  
P J Wormald ◽  
A J Psaltis
Keyword(s):  
Computed Tomography ◽  
Endoscopic Sinus Surgery ◽  
Case Series ◽  
Nasolacrimal Duct ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Retrospective Case ◽  
Computed Tomography Images ◽  
Before And After ◽  
Surgically Induced

AbstractObjectives:To analyse the radiological features of the bony nasolacrimal duct before and after functional endoscopic sinus surgery, and document the incidence of surgically induced dehiscence.Methods:A retrospective case series analysis was conducted of 63 consecutive patients who underwent uncinectomy as a part of 118 functional endoscopic sinus surgical procedures. All patients underwent pre- and post-operative computed tomography scans. Axial computed tomography images at the level of maxillary sinus were evaluated for the presence of bony nasolacrimal duct dehiscence, osteitis and completeness of uncinectomy.Results:The rate of nasolacrimal duct dehiscence prior to surgery was 6.8 per cent (8 out of 118 cases). Nasolacrimal duct dehiscence as a consequence of surgery was observed in 3.3 per cent of cases (4 out of 118), with a further 4.2 per cent (5 out of 118) showing post-operative reactive bony change of the nasolacrimal duct in the absence of dehiscence.Conclusion:The incidence of nasolacrimal duct injury observed was much lower than that previously reported in the literature.

Patient History and Ct Findings in Predicting Surgical Outcomes for Patients with Rhinogenic Headache

2009 ◽  
Vol 88 (5) ◽  
pp. 926-929 ◽  
Author(s):  
Louis J. Mariotti ◽  
Reuben C. Setliff ◽  
Mahmoud Ghaderi ◽  
Spencer Voth
Keyword(s):  
Computed Tomography ◽  
Minimally Invasive ◽  
Endoscopic Surgery ◽  
Surgical Outcomes ◽  
Endoscopic Sinus Surgery ◽  
Primary Treatment ◽  
Sinus Surgery ◽  
Patient History ◽  
Primary Treatment Modality

The concept of rhinogenic headaches remains a subject of much debate. While many authors have reported good results in treating these headaches with endoscopic sinus surgery, few have attempted to establish objective criteria for identifying the best surgical candidates. We conducted a study of 33 adults with rhinogenic headaches to determine if three elements of the history and/or five aspects of computed tomography (CT) would predict which patients might benefit from the minimally invasive sinus technique (MIST) as the primary treatment modality for their headaches. Postoperative follow-up interviews revealed that endoscopic surgery was widely successful, as 28 patients (84.8%) reported improvement. However, we were unable to find any statistically significant history or CT parameters that predicted surgical outcomes.

Surgical Anatomy and Variations of the Onodi Cell

1996 ◽  
Vol 10 (6) ◽  
pp. 365-372 ◽  
Author(s):  
Debra G. Weinberger ◽  
Vijay K. Anand ◽  
Mouwafak Al-Rawi ◽  
Han J. Cheng ◽  
Albert V. Messina
Keyword(s):  
Optic Nerve ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Endoscopic Sinus Surgery ◽  
Sphenoid Sinus ◽  
Internal Carotid ◽  
Surgical Anatomy ◽  
Sinus Surgery ◽  
Ct Scans ◽  
Onodi Cell

Onodi cells are posterior ethmoid cells superolateral to the sphenoid sinus that is intimately associated with the optic nerve. Embryologically, they are derived from ethmoid cells that have undergone dedifferentiation. The anatomic relationship of the Onodi cell to the optic nerve and the internal carotid artery has not been clearly documented in the literature. Forty-four sagittal sections of cadaver heads and 83 CT scans of the sinuses were examined. Case studies of three patients with Onodi cell sinusitis are presented. Two patients underwent endoscopic sinus surgery, and the other chose conservative medical management. The cadaver specimens revealed Onodi cells in 14% (6/44 sections). They were located lateral, superior, or superolateral to the sphenoid sinus. These relationships were further delineated by studying CT scans of the sinuses of 76 patients. Six patients (8%) had Onodi cells. Four of them had a dehiscence of the optic nerve adjacent to the Onodi cell. Twelve patients (16%) demonstrated a dehiscence of the internal carotid artery. These findings have important implications in endoscopic sinus surgery. The anatomic variability of the posterior ethmoids, sphenoid sinus, internal carotid artery, and optic nerve makes this surgical approach particularly challenging.

scholarly journals Onodi cells and endoscopic sinus surgery

2020 ◽  
Vol 6 (6) ◽  
pp. 1041
Author(s):  
Manish Munjal ◽  
Suneet Bhatia ◽  
Porshia Rishi ◽  
Nitika Tuli ◽  
Harjinder Singh ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Optic Nerve ◽  
Endoscopic Sinus Surgery ◽  
Sphenoid Sinus ◽  
Surgical Intervention ◽  
Sinus Surgery ◽  
Optic Nerve Injury ◽  
Medical College ◽  
Computed Tomographic ◽  
Operative Evaluation

<p class="abstract"><strong>Background:</strong> The optic nerve is susceptible to injury during endoscopic surgical intervention in the sphenoethmoidal region.</p><p class="abstract"><strong>Methods:</strong> This was a retrospective analysis of 157 axial computed tomography sections through the sphenoid sinus of randomly selected cases from the departments of Otorhinolaryngology and Neurosurgery, Dayanand Medical College and Hospital, Ludhiana was undertaken during the period 2002 to 2004.  </p><p class="abstract"><strong>Results:</strong> A computed tomographic study of the Onodi cells, of this region was carried out in 157 axial scans. The incidence of Onodi cells was 12.10% with predominance of left sided and indirect type of cells in our study.</p><p class="abstract"><strong>Conclusions:</strong> Thorough pre-operative evaluation of sphenoethmoidal region optic nerve and extent of pathology is essential to avoid the irreversible complication of optic nerve injury.</p><p class="abstract"> </p>

Indolent mucormycosis of the paranasal sinus in immunocompetent patients: are antifungal drugs needed?

2013 ◽  
Vol 127 (9) ◽  
pp. 872-875 ◽  
Author(s):  
H Jung ◽  
S K Park
Keyword(s):  
Computed Tomography ◽  
Paranasal Sinus ◽  
Endoscopic Sinus Surgery ◽  
Clinical Symptoms ◽  
Antifungal Drugs ◽  
Sinus Surgery ◽  
Bony Destruction ◽  
Immunocompetent Patients ◽  
Paranasal Sinus Computed Tomography

AbstractObjective:To report the clinical characteristics and treatment outcomes of indolent paranasal mucormycosis in immunocompetent individuals.Materials and methods:A retrospective review of four immunocompetent patients with indolent mucormycosis of the paranasal sinus managed by endoscopic sinus surgery only was performed. One year of regular follow up comprised angled endoscopy and repeated paranasal sinus computed tomography three months after surgery.Results:Clinical symptoms were non-specific. Pre-operative paranasal sinus computed tomography showed opacification of the unilateral maxillary sinus with focal calcification but without bony destruction or extension to the orbit or cranium. All patients underwent endoscopic sinus surgery without administration of antifungal agents. There was no recurrence on regular clinical and radiological follow up.Conclusion:For indolent paranasal mucormycosis in immunocompetent patients, endoscopic sinus surgery can be the treatment of choice, and the administration of antifungal drugs may not be necessary.

Optic Neuritis following Endoscopic Sinus Surgery

1993 ◽  
Vol 7 (6) ◽  
pp. 247-256
Author(s):  
Perry J. Johnson ◽  
James V. Huerter ◽  
John D. Peters ◽  
Richard H. Legge
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Case Report ◽  
Optic Neuritis ◽  
Endoscopic Sinus Surgery ◽  
Visual Loss ◽  
Sinus Surgery ◽  
High Dose ◽  
Inflammatory Condition ◽  
Rule Out

A case report of optic neuritis, a previously unreported complication following endoscopic sinus surgery, is presented with a review of the diagnosis, postulated pathophysiology, and treatment. Optic neuritis is an inflammatory condition involving the optic nerve and should be considered in the differential diagnosis inpatients who present with ocular complaints following endoscopic sinus surgery. Aggressive evaluation including computed tomography of the orbit and paranasal sinuses to rule out retroorbital hematoma, abscess or bony dehiscence, as well as ophthalmology consultation is essential. Prompt recognition of optic neuritis and institution of high dose corticosteroids and antibiotics may prevent visual loss.

scholarly journals Endoscopic Visualization of the True Maxillary Ostium Following Uncinectomy

2019 ◽  
Vol 99 (6) ◽  
pp. 384-387 ◽  
Author(s):  
Omar H. Ahmed ◽  
Marissa P. Lafer ◽  
Ilana Bandler ◽  
Elcin Zan ◽  
Binhuan Wang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Retrospective Study ◽  
Chronic Rhinosinusitis ◽  
Study Design ◽  
Endoscopic Sinus Surgery ◽  
Nasolacrimal Duct ◽  
Sinus Surgery ◽  
Academic Hospital ◽  
Preoperative Ct

Objectives: To examine the frequency in which angled endoscopes are necessary to visualize the true maxillary ostium (TMO) following uncinectomy and prior to maxillary antrostomy. Additionally, to identify preoperative computed tomography (CT) measures that predict need for an angled endoscope to visualize the TMO. Study Design: Retrospective study. Setting: Tertiary academic hospital. Patients and Methods: Patients who underwent endoscopic sinus surgery (ESS) between December of 2017 and August of 2018 were retrospectively identified. Cases were reviewed if they were primary ESS cases for chronic rhinosinusitis without polyposis and if they were at least 18 years of age. Results: Sixty-three maxillary antrostomies were reviewed (82.5% were from bilateral cases). Thirty-five cases (55.6%) required an angled endoscope in order to visualize the TMO. Of the preoperative CT measures examined, a smaller sphenoid keel-caudal septum-nasolacrimal duct (SK-CS-NL) angle was significantly associated with need for an angled endoscope intraoperatively to visualize the TMO (17.1° SD ± 3.2 vs 15.0° SD ± 2.9; P = .010). Conclusion: Angled endoscopes are likely required in the majority of maxillary antrostomies to visualize the TMO. This is important to recognize in order to prevent iatrogenic recirculation. The SK-CS-NL angle may help to identify cases preoperatively which require an angled endoscope to identify the TMO during surgery.

Computed Tomography Anatomy of the Optic Canal

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P74-P74 ◽  
Author(s):  
Catherine K Hart ◽  
Lee A Zimmer
Keyword(s):  
Computed Tomography ◽  
Optic Nerve ◽  
Sphenoid Sinus ◽  
Optic Canal ◽  
Canal Wall ◽  
Nerve Decompression ◽  
Computed Tomography Images ◽  
Optic Nerve Decompression ◽  
Wide Range ◽  
Potential Area

Objective (1) Analyze the radiographic anatomy of the optic canal in relationship to the sphenoid sinus. (2) Understand the role variation in optic canal anatomy may have in the variability of outcomes in optic nerve decompression. Methods Fine cut computed tomography images of the sinuses were obtained with an IRB waiver. Optic canal dimensions were measured on sinus computed tomography images of 96 patients. 191 optic canals were analyzed (111 females, 80 males). Student T-test calculations were performed for statistical analysis on computer software. Results The average medial canal wall length was 1.48 centimeters (range 0.7–2.3). The length in males was 1.61 centimeters (1.1–2.3) as compared to 1.39 centimeters (0.7–2.0) in females (p=8.0–7). The average degree of exposure of the optic canal exposed to the sphenoid sinus was 101.3 degrees (56–176). The degree of exposure was 105.6 in males versus 98.2 in females (p=.01). The potential area of canal exposed to the sphenoid sinus was 0.66 centimeters squared or 28% of the total surface area. The potential area exposed to the sphenoid sinus in males was 0.76cm2 (28%) and 0.58 centimeters squared (27%) in females. Conclusions A wide range in medial canal wall length and exposure of the bony optic canal to the sphenoid sinus exists on CT images. The variation in medial canal wall length and in optic canal exposure to the sphenoid sinus may contribute to the variability in success rates of endoscopic optic nerve decompression for optic neuropathy.

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