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.

Relationship between sphenoid sinus volume and protrusion of internal carotid artery and optic nerve: a 3D segmentation study on maxillofacial CT-scans

2019 ◽  
Vol 41 (5) ◽  
pp. 507-512 ◽  
Author(s):  
Daniele Gibelli ◽  
Michaela Cellina ◽  
Stefano Gibelli ◽  
Annalisa Cappella ◽  
Antonio Giancarlo Oliva ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Sphenoid Sinus ◽  
Internal Carotid ◽  
Ct Scans ◽  
3D Segmentation

scholarly journals The central Onodi Cell: A Previously Unreported Anatomic Variation

2013 ◽  
Vol 4 (1) ◽  
pp. ar.2013.4.0047 ◽  
Author(s):  
Deepa V. Cherla ◽  
Senja Tomovic ◽  
James K. Liu ◽  
Jean Anderson Eloy
Keyword(s):  
Optic Nerve ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Sphenoid Sinus ◽  
Internal Carotid ◽  
Anatomic Variation ◽  
Optic Canal ◽  
Endoscopic Imaging ◽  
Onodi Cell ◽  
Unique Variation

Preoperative recognition of the Onodi cell is necessary to avoid injury to closely associated structures, including the internal carotid artery and the optic nerve. This article describes the central Onodi cell, a variation in which a posterior ethmoid cell lies superior to the sphenoid sinus in a midline position with at least one optic canal bulge. To our knowledge, this anatomic variation has not been previously reported in the literature. Radiographic and endoscopic imaging of this unique variation is provided.

Profuse epistaxis following sphenoid surgery: a ruptured carotid artery pseudoaneurysm and its management

2008 ◽  
Vol 123 (6) ◽  
pp. 692-694 ◽  
Author(s):  
D Biswas ◽  
A Daudia ◽  
N S Jones ◽  
N S McConachie
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Sphenoid Sinus ◽  
Internal Carotid ◽  
Rare Complication ◽  
Gain Control ◽  
Sinus Surgery ◽  
Unusual Complication ◽  
Subsequent Formation ◽  
Artery Pseudoaneurysm

AbstractObjective:We report a rare case of iatrogenic pseudoaneurysm of the internal carotid artery secondary to endoscopic sphenoid surgery.Method:The management of this unusual complication and a review of the literature are presented.Results:A 65-year-old woman presented with intractable epistaxis four days following endoscopic sphenoid sinus surgery. Initial, conservative measures were unsuccessful in controlling bleeding. The clinical picture of delayed, severe epistaxis after a sphenoid sinus exploration raised the possibility of injury to the internal carotid artery and subsequent formation of a false aneurysm. The patient's pseudoaneurysm was managed, without visualising it, by packing the sphenoid sinus (achieved by palpating 1 cm above the shoulder of the posterior choana) in order to gain control of the haemorrhage, followed by endovascular occlusion.Conclusion:An awareness of this rare complication is essential in order to manage this life-threatening condition efficiently.

scholarly journals Assessment of Sphenoid Sinus Variations and Its Related Neurovascular Structures Using Contrasted Thin Slice Computed Tomography Scan Of The Brain

2018 ◽  
Vol 17 (1) ◽  
Author(s):  
Nawal Ahmed ◽  
Emad Nafie ◽  
Radhiana Hassan ◽  
Hafizah Binti Pasi
Keyword(s):  
Optic Nerve ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Sphenoid Sinus ◽  
Internal Carotid ◽  
Attachment Site ◽  
Anatomical Variations ◽  
Brain Scans ◽  
Neurovascular Structures ◽  
Tomography Scan

Introduction: Sphenoid sinus is the most variable structure in human. The prevalence of anatomical variations varies with the population. Increasing endoscopic procedures around the sphenoid sinus and advances in imaging techniques, allowed precise evaluation of sinus anatomical variation in each population. This study measured the prevalences and described the variations of the sphenoid sinus using thin slice contrasted computed tomography scan of brain scans. Materials and Methods: A retrospective cross-sectional study of 250 brain scans of patients between 18-60 years old attending Hospital Tengku Ampuan Afzan, Kuantan, Pahang from 1st January to 31st December 2017. The sphenoid sinus pneumatization types, volume, optic nerve relation according to Delano’s classification, internal carotid artery relation, and the number of sinus septum and attachment site were studied. Results: Post sellar pneumatization type was most common (52%). The mean sinus volume was 19 cm³ which was significantly different between genders. Delano optic nerve type 1 was most frequent (43%) and most were seen bilaterally with significant differences between gender. The internal carotid artery was seen non-protruded 41.6% cases, protruded in 36.4% cases, and protrusion with wall dehiscence in 22% cases. Two septate sinuses were more prominent (44.3%), aseptate sinus in 2.4% cases. The principle septa attachment site was sella (28%), internal carotid artery related septa found in 10% cases and 3.2% of cases with optic nerve septal attachment. Conclusion: This study revealed the presence of all sphenoid sinus variations amongst the study population. The preoperative determination of these anatomical variations minimizes vital neurovascular structures injury.

Unusually Deep Intracranial Extension of Instrument with Internal Carotid Artery Injury during Functional Endoscopic Sinus Surgery

2014 ◽  
Vol 7 (3) ◽  
pp. 135-138
Author(s):  
Kamble J Harsha ◽  
K Parameswaran ◽  
Akash K George ◽  
Anu Thomas
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Endoscopic Sinus Surgery ◽  
Internal Carotid ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Intracranial Extension ◽  
Carotid Artery Injury ◽  
Artery Injury ◽  
Internal Carotid Artery Injury

ABSTRACT Functional endoscopic sinus surgery is a widely accepted technique, performed extensively in conjugation with septoplasty and paranasal sinus disorders, with good results and minimal complications. Even though, extreme care is required during surgery due to the proximity of the sinuses to the eyes, optic nerves, brain and internal carotid arteries. Here we report a rare case of unusually deep intracranial extension of instrument with internal carotid artery injury during functional endoscopic sinus surgery. How to cite this article Harsha KJ, Parameswaran K, George AK, Thomas A. Unusually Deep Intracranial Extension of Instrument with Internal Carotid Artery Injury during Functional Endoscopic Sinus Surgery. Clin Rhinol An Int J 2014;7(3):135-138.

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