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>

Sphenoid sinus mucocele: 10 cases and literature review

2009 ◽  
Vol 124 (1) ◽  
pp. 44-47 ◽  
Author(s):  
S R Soon ◽  
C M Lim ◽  
H Singh ◽  
D S Sethi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Endoscopic Sinus Surgery ◽  
Sphenoid Sinus ◽  
Sinus Surgery ◽  
Nasal Discharge ◽  
Resonance Imaging ◽  
Presenting Symptoms ◽  
Singapore General Hospital

AbstractIntroduction:Sphenoid sinus mucoceles represent only 1–2 per cent of all paranasal sinus mucoceles. Patients may present with a myriad of symptoms. Pre-operative investigations include nasoendoscopy, computed tomography and/or magnetic resonance imaging. Treatment is by endoscopic sinus surgery.Methodology:A retrospective review of the archives of the Singapore General Hospital otolaryngology department (1999–2006) identified 10 cases of sphenoid sinus mucocele. Patient demographics, presenting symptoms, investigations and treatment were evaluated.Results:The 10 patients identified (three women and seven men) had a mean age of 54.5 years (range 24–70 years). Thirty per cent of patients had a history of nasopharyngeal carcinoma treated with radiotherapy. Presenting symptoms, in order of decreasing frequency, were: ocular symptoms (50 per cent), headaches (30 per cent), nasal discharge (30 per cent) and facial pain (10 per cent). All patients underwent pre-operative computed tomography or magnetic resonance imaging. Twenty per cent of patients had evidence of intracranial involvement on imaging. All patients underwent uncomplicated transnasal sphenoidotomy and drainage of the mucocele. There was no clinical or radiological evidence of recurrence at a mean follow up of 29 months (range 4–90 months).Conclusion:Sphenoid sinus mucocele is a rare condition. In this study, radiation to the head and neck appeared to be a predisposing factor, and eye symptoms were the commonest presentation. Endoscopic sinus surgery is a safe and effective treatment modality.

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.

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.

Relationship of the Optic Nerve to the Paranasal Sinuses as Shown by Computed Tomography

1987 ◽  
Vol 96 (4) ◽  
pp. 331-335 ◽  
Author(s):  
Stephen F. Bansberg ◽  
Stephen G. Harner ◽  
Glenn Forbes
Keyword(s):  
Computed Tomography ◽  
Optic Nerve ◽  
High Resolution ◽  
Sphenoid Sinus ◽  
Computed Tomographic ◽  
Sinus Cavity ◽  
Bony Plate ◽  
Ethmoid Sinuses ◽  
Relationship Of ◽  
Sphenoid Sinuses

Restricted exposure and inconsistencies in sinus pneumatization place the optic nerve at risk during operations on the sphenoid sinus and posterior ethmoid cells. In this study, computed tomography was used to examine these relationships. We reviewed 80 patients who underwent high-resolution computed tomographic scanning for ophthalmologic complaints in which the scan was negative. Forty-eight percent of posterior ethmoid cells are separated from the optic nerve by the thin bony lamina of the optic canal. Nearly 90% of sphenoid sinuses contact the ipsilateral optic nerve and 10% contact both nerves. Eight percent of posterior ethmoid cells override the ipsilateral sphenoid sinus and contact the optic nerve on that side. Paraxial reformatted displays allowed estimation of the degree of projection of the optic nerve into adjacent sinus cavities. Three percent of optic nerves have significant projection into the posterior ethmoid cell, and 23% project significantly into the sphenoid sinus. The width of the bony plate that separates the optic nerve from the sinus cavity was the same for sphenoid and ethmoid sinuses. Although sinus pneumatization varies among individuals, right and left sides are generally similar within one person.

scholarly journals Bilateral concha bullosa with right sided extensive rhinolith: a case report

2019 ◽  
Vol 5 (4) ◽  
pp. 1122
Author(s):  
Sumit Prinja ◽  
Jailal Davessar ◽  
Gurbax Singh ◽  
Simmi Jindal ◽  
Alisha Bali
Keyword(s):  
Computed Tomography ◽  
Paranasal Sinus ◽  
Nasal Obstruction ◽  
Paranasal Sinuses ◽  
Endoscopic Sinus Surgery ◽  
Anatomical Variations ◽  
Sinus Surgery ◽  
Anatomic Variations ◽  
Concha Bullosa ◽  
Medical College

<p class="abstract">Anatomic variations of the paranasal sinuses can lead to various diseases per se. The paranasal sinus anatomy should be carefully examined prior to performing endoscopic sinus surgery in terms of both existent pathologies and anatomic variations. The anatomy of the paranasal sinuses and its variations have gained importance, along with advances in coronal paranasal sinus computed tomography and extensive use of endoscopic sinus surgery. Rhinolith is a mass resulting from calcification of an endogenous or exogenous nidus within the nasal cavity. It is an uncommon disease that may present asymptomatically or cause symptoms like headache and nasal obstruction. A 24 year old woman was admitted in ENT department of GGS Medical College and Hospital, Faridkot with complaints of nasal obstruction, anosmia and headache persisting for 5 years. Right sided rhinolith was detected on anterior rhinoscopy. Bilateral concha bullosa with right sided rhinolith was reported on preoperative paranasal computed tomography scan. It is known that the paranasal sinuses have a number of anatomical variations. Sometimes severe anatomic variations predispose to rhinosinusitis. Herein we report a rare case, along with a review of the literature, to emphasize that severe anatomical variations should not be ignored.</p>

scholarly journals Use of Computed Tomography (CT scan) for delineating anatomy and variation of frontal Sinus before Functional Endoscopic Sinus Surgery

2022 ◽  
Vol 9 (3) ◽  
pp. 54-57
Author(s):  
Sajjad Ali Hashmi Syed ◽  
Sadaf Tanveer Khan ◽  
Jawwad Ali Hashmi Syed
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Paranasal Sinuses ◽  
Endoscopic Sinus Surgery ◽  
Frontal Sinus ◽  
Anatomical Variations ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Medical College ◽  
Orbital Roof

Abstract Introduction: For Functional Endoscopic Sinus Surgery (FESS), the surgeon needs an accurate depiction of the anatomy of paranasal sinuses and their variations. Computed tomography (CT Scan) fulfills this requirement by providing detailed anatomy, the anatomical variants, and the extent of the disease in and around the Para nasal sinuses. The aim of this study is to show the anatomy of the Frontal sinus as delineated by the computed tomography. Materials and Methods: STUDY DESIGN: Cross section Descriptive Study. Out of 337 patients above 12 years of age who were referred for computed tomography of paranasal sinuses in the Dept. of Radio- Diagnosis, Govt. Medical College and Hospital from December 2015 till October 2017, 200 adults(males and females) were randomly selected.Of the 200 subjects studied 37(18.5%) subjects had hypoplastic/ non or poorly pneumatised frontal sinuses of which 31 (15.5%) were bilateral and 6 (3%) were unilateral i.e. on right side. Observations and results: Intra frontal cell were seen in about 64 (32%) subjects of which 26 (13%) on right side, 24 (12%) were on left side and 14 (7%) were bilateral. Extension of pneumatisation into crista galli was seen in 16 (8%) subjects and into orbital roof was seen in 6 (3%) subjects. Conclusion: The findings in this study show that anatomical variations in the Para nasal sinuses and nasal cavity are common. Computed tomography is fundamental radiologic investigation for diagnosis of the Sino nasal lesions or pre and post-surgical assessment.

scholarly journals Odontogenic Maxillary Sinusitis: Therapeutic Management of Cases with Oroantral Fistulae

Sinusitis ◽  
2021 ◽  
Vol 5 (1) ◽  
pp. 53-58
Author(s):  
Yasutaka Yun ◽  
Masao Yagi ◽  
Tomofumi Sakagami ◽  
Shunsuke Sawada ◽  
Yuka Kojima ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Surgical Intervention ◽  
Maxillary Sinusitis ◽  
Sinus Surgery ◽  
Fistula Closure ◽  
Treatment Resistant ◽  
Oroantral Fistula

Odontogenic maxillary sinusitis (OMS) is a disease in which inflammation from the teeth extend into the maxillary sinus, causing symptoms of unilateral sinusitis. OMS can recur, with some being resistant to antibiotics. In intractable cases, exodontia and endoscopic sinus surgery (ESS) are necessary treatments. Here we report our analysis on the indications for surgical intervention in cases diagnosed with and treated as OMS. We retrospectively examined 186 patients who were diagnosed with sinusitis on a computed tomography (CT) scan. For cases diagnosed with OMS, the site of the causative tooth and the presence or absence of oroantral fistula to the maxillary sinus was examined. In addition, we analyzed the therapeutic efficacy of the initial treatment of antibiotics, and what the indications were for ESS. Among the patients examined, OMS was diagnosed in 44 cases (23.6%). In 14 out of 20 cases that underwent a post-medical treatment CT scan, OMS found to be treatment-resistant. Of these 14 cases, 12 (88%) had oroantral fistulae to the maxillary sinus. In all cases where exodontia, fistula closure surgery, and endoscopic sinus surgery (ESS) were performed, the fistula disappeared and the shadow of inflammation in the paranasal sinus improved. In OMS with oroantral fistula, ESS, exodontia, and fistula closure should be recommended over medication such as macrolide therapy.

Calculation of an Optic Nerve Injury Risk Profile Before Sphenoid Sinus Surgery

2017 ◽  
Vol 28 (1) ◽  
pp. e75-e78
Author(s):  
Erdem Atalay Cetinkaya ◽  
Koray Koc ◽  
Mehmet Fatih Kucuk ◽  
Pinar Koc ◽  
Nuray Bayar Muluk ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Nerve Injury ◽  
Sphenoid Sinus ◽  
Injury Risk ◽  
Risk Profile ◽  
Sinus Surgery ◽  
Optic Nerve Injury

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.

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