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Small Onodi cell mucocele causing chronic optic neuropathy: case report.
Hitoshi Fukuda1, Ryu Fukumitsu, Mitsushige Andoh
1Department of Neurosurgery, National Hospital Organization Himeji Medical Center, Himeji, Hyogo, Japan.
Neurologia Medico-Chirurgica
|October 30, 2010
Summary
A rare Onodi cell mucocele, a small cyst in the ethmoid sinus, caused chronic optic neuropathy in a patient. Surgical removal relieved vision loss, highlighting this unusual cause of optic nerve dysfunction.
Area of Science:
- Otolaryngology
- Neurology
- Ophthalmology
Background:
- Onodi cell mucoceles are rare cysts arising from the posterior ethmoid air cells.
- These mucoceles can extend into adjacent structures, including the optic canal.
- Optic neuropathy is an uncommon complication of Onodi cell mucoceles.
Observation:
- A 45-year-old woman presented with gradual, unilateral visual disturbance.
- Neuroimaging revealed a small cystic lesion in the left posterior ethmoid sinus extending into the anterior clinoid process.
- The lesion contained mucinous fluid upon surgical exploration.
Findings:
- Histological examination confirmed the lesion as a mucocele.
- The final diagnosis was a small, isolated Onodi cell mucocele.
- The mucocele was surgically removed via a pterional epidural approach, including unroofing of the optic canal.
Implications:
- This case demonstrates that small Onodi cell mucoceles can cause significant optic neuropathy.
- Early diagnosis and surgical intervention are crucial for visual recovery.
- Highlights the importance of considering sinonasal pathologies in the differential diagnosis of optic neuropathy.
