Fukuda Yoichiro, Chikamatsu Kazuaki, Ninomiya Hiroshi, Yasuoka Yoshihito, Miyashita Motoaki, Furuya Nobuhiko
Department of Otolaryngology-Head and Neck Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi 371-8511, Japan.
Auris Nasus Larynx. 2006 Jun;33(2):199-202. doi: 10.1016/j.anl.2005.11.024. Epub 2006 May 3.
The Onodi cell is a large pneumatized posterior ethmoid cell and closely related to optic nerve. We present an extremely rare case of retrobulbar optic neuropathy caused by mucocele in an Onodi cell. A 79-year-old man complained of headaches and simultaneous bilateral visual disturbance. A computed tomography (CT) scan demonstrated a mucocele in an Onodi cell, which involved bilateral optic nerves. The surgical treatment with a transnasal endoscopic approach was performed, resulting in the improving of visual acuity. The bilateral optic nerves were identified along each lateral wall into an Onodi cell accompanied with bone defect. In an Onodi cell, even if the lesion is isolated and/or small, it may be closely related to ocular symptoms. Imaging studies should be considered for the differential diagnosis because early diagnosis and prompt surgical treatment for mucocele are needed for recovery of visual impairment.
Onodi气房是一个较大的气化后筛窦气房，与视神经关系密切。我们报告一例极为罕见的由Onodi气房黏液囊肿引起的球后视神经炎病例。一名79岁男性主诉头痛及双眼同时出现视力障碍。计算机断层扫描（CT）显示一个Onodi气房内有黏液囊肿，累及双侧视神经。采用经鼻内镜手术治疗，视力得到改善。沿着每个外侧壁进入伴有骨质缺损的Onodi气房，双侧视神经得以辨认。在Onodi气房中，即使病变孤立和/或较小，也可能与眼部症状密切相关。由于黏液囊肿需要早期诊断并及时进行手术治疗以恢复视力损害，因此应考虑进行影像学检查以进行鉴别诊断。
