Presence Of Onodi Cells Research Articles

The relationship between optic nerve and Onodi cells on CT scan

The Onodi cells, also known as sphenoethmoidal air cells, are a variant of the most posterior ethmoid cells and are closely related to the optic canal. The presence of Onodi cells may increase the risk of optic nerve injury and result in confusion with sphenoid sinuses during endoscopic sinus surgery, leading to the oversight of sphenoid sinus pathology. The aim of the study was to examine the characteristics of Onodi cells and their relationship with the optic nerve on CT scans. A cross-sectional study was conducted, analyzing CT scans of paranasal sinuses in 196 posterior ethmoid air cells from 98 patients (30 males and 68 females) aged 18 or older, without abnormalities in the paranasal sinuses and optic nerve anatomy. The prevalence of Onodi cells was 38.78%, with 26.32% on the left, 44.74% on the right, and 28.94% bilaterally. Onodi cell pneumatization was observed in the order of Type I > Type II > Type III on both sides. The most common relationship between Onodi cells and the optic nerve was Type A on both sides. The incidence of the optic nerve bulging into Onodi cells was 50%, and the exposure of the optic nerve into Onodi cells was 7.89%. The study investigated the prevalence and relationship between Onodi cells and the optic nerve. CT scans proved to be a crucial diagnostic tool in providing essential information about Onodi cells before surgery.

Is there a relationship between sphenoid sinus pneumatization and carotid canal–intersinus septa connection?

Objectives We investigated the relationship between sphenoid sinus (SS) pneumatization types, carotid canal types and carotid canal–intersinus septa connection. Methods The paranasal sinus computed tomography (PNSCT) images of 274 patients (141 males and 133 females) were evaluated retrospectively. SS pneumatization, SS intersinus septation, SS intersinus septa deviation, carotid canal classification, carotid canal dehiscence, carotid canal–intersinus septa connection and presence of Onodi cells were evaluated. Results In presellar and sellar SS, type 1 carotid canal was detected. However, type 3 carotid canal was detected more in postsellar SS. On the left side, in 26.4% of the postsellar SS, carotid canal dehiscence was detected. On the right side, carotid canal-intersinus septa connection was detected in 55.8% of the postsellar SS and 35.1% of the sellar SS. On the left side, it was detected 58.3% of the postsellar SS and 30.9% of the sellar SS. In postsellar type SS pneumatized cases, right caroid canal-intersinus septa connection increased by 5.4 fold and left carotid canal-intersinus septa connection increased by 7.3 fold compared to presellar type SS pneumatization. In 2≥ intersinus septa group, left carotid canal-intersinus septa connection increased 5.0 fold compared to ‘no septa’ group. Conclusion In this study, we evaluated SS pneumatization types and their relation with carotid canal types and carotid canal-intersinus septa connections. Type 3 carotid canal (protrudation to SS wall) was detected more in postsellar SS. In these cases, surgeons should be very careful during surgery to avoid damage to the internal carotid artery (ICA).

Factors affecting the location of sphenoid sinus ostium: a binary logistic regression analysis.

Sphenoid sinus is a type of sinus surrounded by critical structures so that its injury potential to induce complications during surgery. The purpose of this study was to investigate the factors affecting the location of the sphenoid sinus natural ostium (SSO) to provide valuable data for endoscopic sinus surgery. Ostiomeatal unit (OMU) computerized tomography (CT) was performed on 198 subjects. Across the left and right sides, 396 evaluation results were obtained. The vertical distance to determine the location of the SSO was analyzed based on Lines 1, 2 and 3 on the sagittal image. The horizontal distance was analyzed based on Lines 4 and 5 on the axial image. The upper, lower, medial and non-medial borders were defined according to the location of the SSO. The presellar, sellar and postsellar types were categorized according to the level of sphenoid sinus pneumatization (SSP) on the sagittal image. The presence and absence of Onodi cells were defined on the coronal image. Binary logistic regression analysis was performed to investigate each factor. As the rostrum width of the SSO on the horizontal position increased, the position toward non-medial boarder increased by 4.902 times so that the natural ostium showed a trend of lateralization. For the postsellar type, compared to the presellar type, the position toward the non-medial boarder decreased by 0.223 times, indicating that the postsellar type had the natural ostium showing a trend of medialization. In the presence of Onodi cells, the position toward the lower boarder increased by 2.599 times with a significant association. The results in this study indicated that the presellar type of SSP had the natural ostium exhibiting lateralization with an increase in the rostrum width, whereas the postsellar type had the natural ostium exhibiting medialization with a decrease in the rostrum width. Based on these findings, the methods to widen the natural ostium may be diversified.

Evaluation of Relationship Between Sphenoid Sinus Septation and Onodi Cells Using Cone-Beam Computed Tomography

Objective: This study aimed to evaluate the sphenoid sinus septation, the presence/absence of Onodi cells, and the relationship between these structures with each other in cone-beam computed tomography. Methods: A total of 500 cases (250 males, 250 females) between the ages of 18 and 81 were included in this study. Sphenoid sinus septations were classified as intersphenoid, multiple, and absent, and Onodi cells as present or absent. The relationship between these parameters was also assessed. Chi square test was used to determine the relationship between sphenoid sinus septation and Onodi cells. Results: Multiple septa seen in 451 (90.2%) of the cases is the most common type of sphenoid septation. Onodi cells were present in 327 (65.4%) of the cases. A statistically significant relationship was detected between Onodi cells and mean age (P < .05) but no significant difference was observed between the septation and mean age (P > .05). There was no significant difference between the septation or Onodi cells with gender (P > .05). Multiple septa were observed in all cases with Onodi cell. The relationship between sphenoid sinus septation and Onodi cell was statistically significant (P < .001). Conclusion: This study revealed that there was a significant relationship between sphenoid sinus septation and Onodi cells. The presence of Onodi cells was observed only with multiple septa. Cone-beam computed tomography is an effective imaging method in the evaluation of sphenoid sinus anatomy and its variations and surrounding anatomical structures.

Anatomical configurations of the optic canal in the sphenoid sinus in a Hispanic population: computed tomography based study.

The prevalence of the optic canal anatomical variants across the sphenoid sinus varies widely among different ethnic groups. This study aimed to analyse the anatomical variants of the optic canal and their relationship to sphenoid sinus pneumatisation in a Hispanic population. A review of 320 sphenoid sinuses by high-resolution computed tomography was performed. DeLano's classification of the optic canal, presence of dehiscence, septa insertion, sphenoid sinus pneumatisation and presence of Onodi cells were established. Dehiscence of the optic canal was observed in 4.7 per cent (n = 15) of the analysed sinuses. Type 4 and 3 optic canals were significantly more frequent among postsellar sphenoid sinuses than other patterns of sphenoid sinus pneumatisation (p = 0.002 and p = 0.018). A type 4 optic canal has a higher tendency to present inserted septum than other optic canal types (p = 0.014). This study described the optic canal variants in a Hispanic population, which complements existing literature addressing other ethnicities.

The relationship between nasal septal deviation and anatomical variations of the paranasal sinus

Objectives: The aim of this study was to determine the relationship between septum deviation and anatomic variations of the paranasal sinus. Methods: A total of 157 (79 males, 78 females) patients between the ages of 17 and 77 years (mean age: 33.7 ± 14.9 years) were included in the study. Using paranasal sinus computed tomography imaging, anatomical variations including nasal septal deviation, Agger nasi cells, Haller cells, Onodi Cells, sphenoid sinus pneumatisation, paradoxical middle turbinates, middle turbinate pneumatisation, maxillary sinus septa,vertical septa in the sphenoid sinus, optic nerve dehiscenceand cribriform plate lamina lateralis height were evaluated. Results: Agger nasi cells were present in 47.1% of cases, Haller cells were seen in 5% of cases and Onodi cells were observed in 23.6% of cases. In 70.1% of cases, one vertical septa in the sphenoid sinus was observed. Maxillary sinus septa was observed in 16.5% of cases. There was a significant negative correlation between the female gender and increased sphenoid sinus pneumatisation (p = 0.035). There was a positive correlation between maxillary sinus septa and the presence of Onodi cells (pright =0.045, pleft = 0.017). There was also a negative correlation between maxillary sinus septa and sphenoid sinus pneumatisation (pright = 0.001, pleft = 0.005). Conclusions: In our study, we found that maxillary sinus septa, Agger nasi, Haller cells, cribriform plate lamina lateralis height, sphenoid sinus septation and Onodi cells were interrelated. We recommend that surgeons evaluate patients with these variations to prevent complications.

Cone Beam Computed Tomography Analysis of Sphenoid Sinus Pneumatization and Relationship with Neurovascular Structures.

The sphenoid sinus is considered as the most variable pneumatized structure of the skull. The aim of the present study was to determine the prevalence of the Onodi cell as well as to evaluate the relationship between the sphenoid sinus type of pneumatization and the presence of surrounding neurovascular protrusion using cone beam computed tomography (CBCT). The CBCT images of 500 patients/996 sides [203 males (40.6%) and 297 females (59.4%)] were analyzed in this study. The type of sphenoid sinus pneumatization, prevalence of internal carotid artery (ICA) and optic nerve (ON) protrusion and dehiscence, and also the frequency of Onodi cell were assessed. The percentages of the conchal, presellar, sellar, postsellar (a), and postsellar (b) types of pneumatization were 1%, 11.5%, 35.5%, 38.9%, and 13.1%, respectively. The more the sphenoid sinuses pneumatized, the greater the frequency of ON and ICA protrusion and dehiscence of their wall to the sinus. The prevalence of Onodi cell was 38.8%. A significant correlation was found between ON dehiscence and the presence of Onodi cells. The present study demonstrated a significant relationship between the sinus type and frequency of neurovascular protrusions. Therefore, the sphenoid sinus extent of pneumatization might be useful in predicting the risk of iatrogenic damage to the surrounding structures.

Prevalence of Onodi Cells in Korean Based on Computed Tomography

Received May 29, 2015 Revised June 26, 2015 Accepted June 27, 2015 Address for correspondence Ji Sun Kim, MD, PhD Department of OtorhinolaryngologyHead and Neck Surgery, Eulji Hospital, Eulji University College of Medicine, 68 Hangeulbiseok-ro, Nowon-gu, Seoul 01830, Korea Tel +82-2-970-8276 Fax +82-2-970-8275 E-mail vicky96@eulji.ac.kr Background and ObjectivesZZThe Onodi cell is the posterior-most ethmoid air cell that lies superior to the sphenoid sinus, and has intimate relationship with the optic nerve. The aim of this study was to evaluate Onodi cell prevalence, protrusion and bony dehiscence of the optic nerve in Korean population using computed tomography (CT). Subjects and MethodZZA retrospective analysis was performed on 129 Korean patients who consecutively underwent CT between January 2014 and December 2014. The presence of Onodi cells and protrusion and bony dehiscence of the optic nerve were analyzed using 3-dimensional CT images. ResultsZZA total of 70 males and 59 females were studied. Onodi cells were present in 61 (47.3%) patients but in 88 CT slides (34.1%); this consisted of 27 Onodi cells found bilaterally (44.3%), 18 on the right side only (29.5%), and 16 on the left only (26.2%). Of the total 61 patients with Onodi cells, the optic nerve protrusion and dehiscence were present in 34.4% and 23.8% of the studied CT slides. There was no statistically significant relationship between the presence of Onodi cells and protrusion and bony dehiscence of the optic nerve. ConclusionZZIn our study, Onodi cells were found in almost half of the patients. This prevalence is higher than previously reported in the literature. In patients with Onodi cells, the optic nerve protrusion and dehiscence were present in about 1/3 and 1/5 of the total slides, respectively. Therefore, the identification of these cells is essential prior to endoscopic sinus and skull base surgery to prevent potential complications. Korean J Otorhinolaryngol-Head Neck Surg 2015;58(12):855-8

Surgical Measurement of the Sphenoid Sinus on Sagittal Reformatted CT in the Turkish Population.

The objectives of this study were to determine sinus measurements specific for the Turkish population using CT sagittal thin-slice reconstruction images and to clarify the three-dimensional anatomical features of the sphenoid sinus, along with its surrounding structures, that are relevant to performing an endoscopic sphenoidotomy. Images of 300 patients (165 female, 135 male) were studied. The research was conducted on the axial plane with a 1 mm slice thickness and a 0.6 mm slice interval, and sagittal reconstruction was performed with a 0.4 mm slice interval. Measurements of the sinus were obtained, and the presence of Onodi cells was researched. Line 1 was found to be significantly shorter in the Turkish patients of this study compared to studies of other populations. Lines 4 and 6 were found to be longer on the left side (Line 4 right: 18.8±3.6 mm, left: 19.3±3.4 mm, p=0.027; Line 6 right: 24.1±6.8 mm, left: 24.3±6.8 mm, p=0.008). Lines 2, 3, 4 and 6 were longer in men than in women (p<0.05). In the Turkish population, Line 1 is shorter, so the risk of skull base perforation is greater. Lines 4 and 6 are longer on the left side; thus, choosing the left ostium in sinus dilation is safer. Because of sex differences regarding Lines 2, 3, 4 and 6, sex should be considered in sphenoid sinus procedures.

Co-existence of the Onodi cell with the variation of perisphenoidal structures

The presence of the Onodi cell (OC) may be accompanied by morphological variations of the neighboring anatomic structures. Such variations carry significant surgical implications and challenges. Pneumatization of the sphenoid sinus induces anterior clinoid pneumatization (ACP), affects the type of the Vidian nerve (VN) canal or alters the courses of the internal carotid artery (ICA), and the optic nerves (ONs) are strongly depending on it. Onodi cell pneumatization may reach and surround the optic nerve in various extension. Our aim in the study was to investigate the effect of Onodi cell's potential co-existence on these structures. This study was planned as a retrospective and cross-sectional study. This study performed in a tertiary referral center. Coronal computerized tomography images of 999 patients were examined. Using an 64 slices tomography machine, images taken at 3-mm sections were reconstructed using a bone algorithm and evaluated. OCs were present at 212 of the total 320 sides in 160 patients. Type-2 was found to be the most prevalent type of VN canal configuration (Type-2: VN canal partially protrudes into the sphenoid sinus or into the floor of the sphenoid) among all patients (66.5 %) and among those with OCs (71.2 %). The presence or absence of the OC did not cause a statistically significant alteration of the intrasphenoidal course of the VN. The presence of OCs was found to be significant (p < 0.01) in accompanying pneumatization of the anterior clinoid process (34.4 %, 73/212), protrusion (80.1 %, 170/212) and dehiscence (36.3 %, 77/212) of the optic nerve, and protrusion (59 %, 125/212) and dehiscence (20.8 %, 44/212) of the ICA. In 108/320 sides where OCs were absent, no significant correlations existed. This study shows that in the co-existence of an OC, ACP, protrusion and dehiscence of the optic nerve and ICA are encountered at significantly higher rates, while the course of the VN is not necessarily altered.

Analysis of Sphenoid Sinus and Surrounding Structures Using Multidetector Computed Tomography

Background and ObjectivesZZSphenoid sinus is surrounded by several important structures and this can make sphenoid sinus surgeries difficult. The aim of this study was to clarify the anatomical features of the sphenoid sinus with its surrounding structures based on 3-dimensional multidetector computed tomography. Subjects and MethodZZWe obtained the sagittal reconstruction images of the sphenoid sinus from of 110 participants and measured various distances in the sphenoid sinus. In addition, we analyzed the impact of anatomical variation on the results of measured distances, such as presence of Onodi cell (Onodi type vs. non-Onodi type) and the location of sphenoid ostium corresponding to the level of sella floor (superior type vs. inferior type). ResultsZZIn the Onodi type, the mean distance from the sphenoid ostium to the roof of sphenoid sinus (5.81±1.12 mm vs. 10.31±2.90 mm, p=0.001) and the mean length of sphenoid sinus roof (4.52±1.00 mm vs. 9.89±4.17 mm, p=0.001) were significantly shorter than those in the non-Onodi type. In superior type, the mean distance from the sphenoid ostium to the floor of sphenoid sinus (12.44±2.63 mm vs. 9.90±2.31 mm, p＜0.001) and that from sphenoid ostium to the posterior wall of sphenoid sinus (13.44±3.27 mm vs. 20.38±7.63 mm, p＜0.001) were significantly longer compared with those in the inferior type. However, the mean distance from the sphenoid ostium to the roof of sphenoid sinus was shorter (7.49±1.86 mm vs. 10.51±3.03 mm, p＜0.001). ConclusionZZThe present study provides anatomical information about sphenoid sinus with important surgical distance measured between the sphenoid ostium and the surrounding structures, which is essential to avoid the complications during sphenoid surgery. � Korean J Otorhinolaryngol-Head Neck Surg 2012;55:95-100 Key WordsZZSphenoid sinus ㆍAnatomic landmarks ㆍRadioanatomic analysis ㆍMultidetector computed tomography.