Tuli Isha Preet, Khandelwal Kirti, Trehan Sandeep, Gupta Ankur, Nathan Karthika
Department of Otorhinolaryngology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, 110029 India.
Medical Council of India, New Delhi, India.
Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):1425-1429. doi: 10.1007/s12070-021-02567-z. Epub 2021 Apr 26.
A mucocele of a paranasal sinus is a mucus filled cystic mass lined by epithelium filling the involved sinus whose ostium is obstructed. While frontoethmoidal mucoceles are common, Onodi cell mucoceles are less frequently seen. Due to its anatomic proximity to optic nerve, it can lead to devastating visual complications. A 29 year old female presented with progressive loss of vision in right eye since 20 days leading to complete loss of vision since 12 days without any nasal complaints. Endoscopy showed fullness in right spheno-ethmoidal region. Computed Tomography scan revealed a mucocoele of the right Onodi air cell causing compression of intracanalicular part of right optic nerve. Despite urgent surgical decompression of mucocele, vision could not be restored. Poor visual acuity at presentation may be associated with bad prognosis. Hence, a high index of suspicion followed by appropriate imaging (CT scan and/or MRI nose and paranasal sinus) is crucial for early diagnosis in case of unexplained progressive diminution of vision, even in setting of no nasal complaints.
鼻窦黏液囊肿是一种充满黏液的囊性肿物，由上皮细胞衬里，填充受累鼻窦，其开口受阻。虽然额筛窦黏液囊肿很常见，但Onodi气房黏液囊肿较少见。由于其在解剖位置上靠近视神经，可导致严重的视力并发症。一名29岁女性，自20天前右眼视力逐渐下降，至12天前完全失明，无任何鼻部不适。内镜检查显示右侧蝶筛区域饱满。计算机断层扫描显示右侧Onodi气房黏液囊肿，压迫右侧视神经管内段。尽管对黏液囊肿进行了紧急手术减压，但视力未能恢复。就诊时视力差可能与预后不良有关。因此，对于不明原因的进行性视力下降，即使没有鼻部不适，高度怀疑并随后进行适当的影像学检查（鼻窦CT扫描和/或MRI）对于早期诊断至关重要。
