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.

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 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.

Endoscopic endonasal approach for a tuberculum sellae meningioma

2012 ◽  
Vol 32 (Suppl1) ◽  
pp. E8 ◽  
Author(s):  
Juan C. Fernandez-Miranda ◽  
Carlos D. Pinheiro-Neto ◽  
Paul A. Gardner ◽  
Carl H. Snyderman
Keyword(s):  
Optic Nerve ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Optic Canal ◽  
Csf Leak ◽  
Endoscopic Endonasal ◽  
Tuberculum Sellae Meningioma ◽  
Tuberculum Sellae

The authors present the technical and anatomical nuances needed to perform an endoscopic endonasal removal of a tuberculum sellae meningioma. The patient is a 47-year-old female with headaches and an incidental finding of a small tuberculum sellae meningioma with no vascular encasement, no optic canal invasion, but mild inferior to superior compression of the cisternal segment of the left optic nerve. Neuroophthalmology assessment revealed no visual defects. Treatment options included clinical observation with imaging follow-up studies, radiosurgery, and resection. The patient elected to undergo surgical removal and an endonasal endoscopic approach was the preferred surgical option. Preoperative radiological studies showed the presence of an osseous ring between the left middle and anterior clinoids, the so-called carotico-clinoidal ring. The surgical implications of this finding and its management are illustrated. The surgical anatomy of the suprasellar region is reviewed, including concepts such as the chiasmatic sulcus and limbus sphenoidale, medial and lateral optico-carotid recesses, and the paraclinoidal and supraclinoidal segments of the internal carotid artery. Emphasis is made in the importance of exposing the distal dural ring of the internal carotid artery and the precanalicular segment of the optic nerve for adequate intradural dissection. The endonasal route allows for early coagulation of the tumor meningeal supply and extensive resection of dural attachments, and importantly, provides an inferior to superior access to the infrachiasmatic region that facilitates complete tumor removal without any manipulation of the optic nerve. The lateral limit of dural removal is formed by the distal dural ring, which is gently coagulated after the tumor is resected. A 45° scope is used to inspect for any residual tumor, in particular at the entrance of the optic nerve into the optic canal and at the most anterior margin of the exposure (limbus sphenoidale). The steps for reconstruction are detailed and include intradural placement of dural substitute and extradural placement of the nasoseptal flap. The nuances for proper harvesting, positioning, and reinforcement of the flap are described. No lumbar drain was used. The patient had an uneventful recovery with no CSF leak or any other complications. Imaging follow-up at 6 months showed complete removal of the tumor. The patient had no sinonasal or neurological symptoms, and olfaction was fully preserved. The video can be found here: http://youtu.be/kkuV-yyEHMg.

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 Anatomical variations of sphenoid sinus among patients undergoing computed tomography of paranasal sinus

2019 ◽  
Vol 5 (4) ◽  
pp. 888 ◽  
Author(s):  
Bhanu Pratap Singh ◽  
Rajendra Basayya Metgudmath ◽  
Divya Singh ◽  
Udit Saxena
Keyword(s):  
Computed Tomography ◽  
Optic Nerve ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Paranasal Sinus ◽  
Sphenoid Sinus ◽  
Internal Carotid ◽  
Three Dimensional ◽  
Maxillary Nerve ◽  
Vidian Nerve

<p class="abstract"><strong>Background:</strong> The approach to sphenoid sinus still remains a clinical challenge, despite the arrival of endoscopy, computed tomography (CT) and functional endoscopic sinus surgery (FESS). The complex and variable anatomy of the sphenoid sinus can be difficult to appreciate with standard axial or coronal CT images of the sinus. The study was done with the objective to study the anatomy of the sphenoid sinus and its variations, and to compare the prevalence of variants obtained in our study with the reported cases in the literature.</p><p class="abstract"><strong>Methods:</strong> The CT scans of 168 normal slides obtained from 84 patients with paranasal sinus were analysed using triplanar imaging provided by 64-slice spiral CT. The prevalence of each of the sphenoid sinus variation was also analysed.  </p><p class="abstract"><strong>Results:</strong> Results showed that the prevalence of pneumatization of the anterior clinoid process, greater wing of the sphenoid, and the pterygoid process was 17.85%, 22.61% and 32.14%, respectively. Protrusion of the internal carotid artery, optic nerve, maxillary nerve, and the vidian nerve was 47.61%, 36.90%, 25% and 26.19%, respectively. Dehiscence of internal carotid artery, optic nerve, maxillary nerve, and the vidian nerve was 30.95%, 29.76%, 14.28% and 22.61%, respectively. The prevalence of pneumatization in the Onodi cells was seen in 17.85% of the cases. Association of septa with an internal carotid artery was seen in 29.7% of the cases. Septa attachment to the optic nerve was also observed in 27.3% of the cases.</p><p class="abstract"><strong>Conclusions:</strong> The triplanar imaging (section thickness of 1 mm) is a better three-dimensional image of the sphenoid sinus, compared to coronal imaging. Triplanar imaging guides the surgical approach of the sphenoid sinus with mentally reconstructed three-dimensional images.</p><p class="abstract"> </p>

scholarly journals Anatomical variations of the sphenoid sinus - a study of 200 cases -

2014 ◽  
Vol 20 (2) ◽  
pp. 57-62 ◽  
Author(s):  
M. Lupascu ◽  
Gh. I. Comsa ◽  
V. Zainea
Keyword(s):  
Optic Nerve ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Sphenoid Sinus ◽  
Internal Carotid ◽  
Anatomical Variation ◽  
Anatomical Variations ◽  
Vidian Canal ◽  
Foramen Rotundum ◽  
Sphenoid Sinuses

Abstract Our study on the anatomical variation of pneumatisation of the sphenoid sinuses was performed on 200 tomographical studies, evaluating the anatomical variations of the sphenoid sinuses and the Onodi cells, the types of pneumatisation according with the types described by Hammer and Radberg, as well as the extensions of pneumatisation towards the anterior clinoid processes, pterygoid processes and sphenoidal wings; the frequency of intrasphenoidal protrusions and dehiscences of internal carotid artery, optic nerve, Vidian canal and foramen rotundum and the presence of primary and secondary septa attached to their canals.

Surgical Anatomy of the Ophthalmic Artery: Its Origin and Proximal Course

2005 ◽  
Vol 57 (suppl_4) ◽  
pp. ONS-236-ONS-241 ◽  
Author(s):  
Phuong Huynh-Le ◽  
Yoshihiro Natori ◽  
Tomio Sasaki
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Ophthalmic Artery ◽  
Internal Carotid ◽  
Anatomic Variation ◽  
Surgical Anatomy ◽  
Optic Canal ◽  
Falciform Ligament ◽  
Surgical Exploration ◽  
Fresh Cadaver

Abstract OBJECTIVE: We examined the surgical anatomy of the ophthalmic artery (OA) by dissection of cadaver heads, evaluating the anatomic relationships between the origin of the OA and both its proximal course and surrounding structures. In addition, we demonstrated the surgical application of these anatomic features for safe surgical exploration of this region. METHODS: Through anatomic dissection, the origin of the OA was examined in both sides of 25 formalin-fixed and 10 fresh cadaver specimens. The following parameters were evaluated: the location of the origin of the OA in relation to the dural rings, the topographic relationship of the paraclinoid region, and the location of the dural penetrating point of the OA in the optic canal. RESULTS: The OA originated from the internal carotid artery within the intradural space in 49% of cases, just above the upper dural ring in 37%, at the clinoid segment in 7%, and within the cavernous sinus in 6%. The dural penetrating point of the OA was anterior to the falciform ligament, and thereby in the optic canal, in 74% of cases, ventral to the falciform ligament in 19%, and posterior to the falciform ligament in 7%. The anterior circumference point of the upper dural ring, the point at which the upper dural ring intersects the anterior edge of the internal carotid artery, was more anterior to the falciform ligament in 40% of cases and ventral and posterior to the falciform ligament in 16.4% and 43.6%, respectively. CONCLUSION: Our anatomic findings demonstrate anatomic variation of the OA in terms of its region of origin. Several anatomic points that were noteworthy during surgical exploration of this region are discussed.

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