Answer for CoW 26 Feb 2017
Onodi cell mucocele
Findings:
T1 hyper T2 heterointense lesion noted with in the left posterior ethmoid sinus and anterior clinoid process region, causing narrowing of left optic canal and left optic nerve compression. The left optic nerve appears atrophied.
Discussion:
The Onodi cell has been defined as a posterior ethmoid cell that has pneumatized laterally and superiorly to the sphenoid sinus. Onodi cells are positioned in the lateral direction, close to the optic nerve and internal carotid artery Paranasal sinus mucoceles are caused by the obstruction in the ductus of mucous glands. Mucoceles are expansile lesions and can cause erosion on the paranasal sinus walls. Mucoceles are often caused by inflammation of the sinus ostium. However trauma, tumors, polyposis and surgical manipulations can cause mucoceles. The importance of this is the close relationship between posterior ethmoid cells and the optic nerve. Onodi cell shows the close anatomical relationship with the optic nerve and internal carotid artery. Onodi cell mucoceles are rare but they may cause vision loss which can lead to medical emergencies. Therefore, it is necessary to carry out detailed investigation of the anatomy of the paranasal sinuses and recognize possible variations. This will result in accurate diagnosis of patients, and allow physicians to plan for and manage any complications that may arise.
Findings:
T1 hyper T2 heterointense lesion noted with in the left posterior ethmoid sinus and anterior clinoid process region, causing narrowing of left optic canal and left optic nerve compression. The left optic nerve appears atrophied.
Discussion:
The Onodi cell has been defined as a posterior ethmoid cell that has pneumatized laterally and superiorly to the sphenoid sinus. Onodi cells are positioned in the lateral direction, close to the optic nerve and internal carotid artery Paranasal sinus mucoceles are caused by the obstruction in the ductus of mucous glands. Mucoceles are expansile lesions and can cause erosion on the paranasal sinus walls. Mucoceles are often caused by inflammation of the sinus ostium. However trauma, tumors, polyposis and surgical manipulations can cause mucoceles. The importance of this is the close relationship between posterior ethmoid cells and the optic nerve. Onodi cell shows the close anatomical relationship with the optic nerve and internal carotid artery. Onodi cell mucoceles are rare but they may cause vision loss which can lead to medical emergencies. Therefore, it is necessary to carry out detailed investigation of the anatomy of the paranasal sinuses and recognize possible variations. This will result in accurate diagnosis of patients, and allow physicians to plan for and manage any complications that may arise.
Note:
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!