Department of Otorhinolaryngology, Head and Neck Surgery, Peking University People's Hospital, Beijing, China.
Department of Ophthalmology, Peking University People's Hospital, Beijing, China.
Ear Nose Throat J. 2024 Nov;103(11):724-730. doi: 10.1177/01455613221080069. Epub 2022 Feb 25.
The objective is to describe the clinical features, treatments, and outcomes of a case series of patients with Onodi cell mucocele, with or without cholesterol granuloma (CG).
We retrospectively reviewed the medical records of eight patients diagnosed with Onodi cell mucocele at a single tertiary care university hospital in Beijing, China, between January 2017 and September 2020. Data regarding nasal symptoms, ocular symptoms, sinus computed tomography findings, treatments, histopathological results, and clinical outcomes were extracted.
We identified eight patients (six men and two women) of an average age of 48.1 (range, 26-70) years. Four patients presented nasal symptoms. Three patients presented ocular symptoms. Among them, one patient experienced concurrent nasal and ocular symptoms. Two patients were diagnosed based on a physical examination in the absence of nasal or ocular symptoms. All patients underwent endoscopic sinus surgery. The pathological specimens showed mucocele in four cases and mucocele with CG in the other four cases. Among the four cases with CG, three cases presented with decreased vision. After endoscopic sinus surgery, one patient recovered completely, and two patients showed significant improvement.
If Onodi cell opacity is observed, especially with optic neuropathy, mucocele and CG are important differential diagnoses. The combination of mucocele and CG is more likely to promote bone destruction and cause serious optic neuropathy than simple mucocele. Endoscopic sinus surgery is appropriate. Diagnoses, treatments, and follow-up should be performed by a multidisciplinary team.
描述一组伴有或不伴有胆固醇肉芽肿（CG）的 Onodi 细胞粘液囊肿患者的临床特征、治疗方法和结局。
我们回顾性分析了 2017 年 1 月至 2020 年 9 月期间在北京一家三级甲等医院诊断为 Onodi 细胞粘液囊肿的 8 例患者的病历资料。提取了鼻部症状、眼部症状、鼻窦计算机断层扫描结果、治疗方法、组织病理学结果和临床转归等数据。
我们共纳入 8 例患者（6 例男性，2 例女性），平均年龄为 48.1 岁（范围 26-70 岁）。4 例患者有鼻部症状，3 例患者有眼部症状，其中 1 例患者同时存在鼻部和眼部症状。2 例患者在无鼻部或眼部症状的情况下通过体格检查诊断。所有患者均接受了鼻内镜鼻窦手术。病理标本显示 4 例为粘液囊肿，4 例为粘液囊肿伴 CG。在 4 例 CG 中，3 例患者出现视力下降。鼻内镜鼻窦手术后，1 例患者完全恢复，2 例患者明显改善。
如果观察到 Onodi 细胞不透明，特别是伴有视神经病变，粘液囊肿和 CG 是重要的鉴别诊断。粘液囊肿伴 CG 的组合比单纯粘液囊肿更有可能促进骨破坏并导致严重的视神经病变。鼻内镜鼻窦手术是合适的。应由多学科团队进行诊断、治疗和随访。
