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Rhinogenic Optic Neuropathy with No Light Perception Secondary to Onodi Cell Mucocele with Visual Recovery after
Noah Shaikh1, John Nguyen1, Christopher Eric Bailey1
1Department of Otolaryngology, West Virginia University, Morgantown, WV, USA.
Ear, Nose, & Throat Journal
|April 13, 2023
Summary
Rhinogenic optic neuropathy, caused by sinus issues, can impair vision. In a unique case, endoscopic sinus surgery combined with optic nerve decompression was necessary to restore sight.
Area of Science:
- Otolaryngology
- Neurology
- Ophthalmology
Background:
- Rhinogenic optic neuropathy (RON) stems from ethmoid or sphenoid sinus inflammation, impacting the optic nerve.
- Current treatments like endoscopic surgery offer variable vision restoration outcomes.
- Evidence supporting optic nerve decompression (OND) in RON is limited.
Purpose of the Study:
- To present a unique case of RON caused by an Onodi cell mucocele.
- To evaluate the efficacy of combined endoscopic mucocele drainage and OND for vision improvement.
Main Methods:
- Case report of a patient with RON secondary to an Onodi cell mucocele.
- Surgical intervention involving endoscopic mucocele drainage.
- Subsequent optic nerve decompression (OND) procedure.
Main Results:
- Isolated endoscopic mucocele drainage provided insufficient visual improvement.
- Additional optic nerve decompression was required to achieve vision enhancement.
- This case highlights a complex RON presentation requiring multi-stage surgical intervention.
Conclusions:
- Onodi cell mucoceles can cause significant optic nerve compression.
- A staged surgical approach, including OND, may be crucial for vision recovery in select RON cases.
- This case expands understanding of RON management strategies.
