European Archives of Oto-Rhino-Laryngology

, Volume 276, Issue 4, pp 1057–1064 | Cite as

Is there a relationship between Onodi cell and optic canal?

  • Adnan Özdemir
  • Nuray Bayar MulukEmail author
  • Neşe Asal
  • Mehmet Hamdi Şahan
  • Mikail Inal



We investigated the relationship between Onodi cells and optic canal by paranasal sinus computed tomography (PNSCT).


In this retrospective study, 508 PNSCT (265 males and 243 females) was examined. Onodi cell presence, pneumatization types, optic canal types; and also sphenoid sinusitis and anterior clinoid process pneumatization were evaluated.


The prevalence of Onodi cells was 21.2% of the patients. Onodi cells were observed 40.7% on the right side and 25.9% on the left side. In 33.4% of the patients, bilateral Onodi cells were present. Male/Female ratio was 24.5%/17.6%. Onodi cell types were detected as Type I > Type II > Type III bilaterally. There was a positive correlation between the right and left Onodi cell types (p < 0.05). Optic canal types were detected as Type IV > Type I > Type II > Type III. bilaterally. There was a positive correlation between right and left optic canal types. Onodi cell presence and ACP pneumatization were found as statistically significant (p < 0.05). In 65.5% of the patients, Onodi cells and ACP pneumatization were absent. ACP pneumatization was present in 35.4% of the cases. In nine cases, bilateral Onodi cells and ACP pneumatization were detected. Sphenoid sinusitis was detected in 11.4% of Type I and 13.8% of the Type II Onodi cells on the right side. On the left side, it was detected in 12.9% of the Type I and 19.0% of Type II Onodi cells.


Identification of Onodi cell is very important clinically because of its proximity to optic nerve canal. We concluded that type IV Onodi–optic canal relationship was the most common finding in our study. Onodi cell presence and their patterns of pneumatization must be evaluated on PNSCT preoperatively to avoid optic canal damage.


Onodi cell Pneumatization types Optic canal Sphenoid sinusitis Anterior clinoid process pneumatization Paranasal sinus computed tomography 


Author contributions

AO: planning, designing, data collection, literature survey. NBM: planning, designing, literature survey, statistical analysis, writing. NA: planning, designing, literature survey. MHS: planning, designing, literature survey. MI: planning, designing, data collection, literature survey.


There is no funding for this article.

Compliance with ethical standards

Financial disclosure

There is no financial disclosures of the authors.

Conflict of interest

The author Adnan Özdemir declares that he has no conflict of interest. The author Nuray Bayar Muluk declares that she has no conflict of interest. The author Neşe Asal declares that she has no conflict of interest. The author Mehmet Hamdi Şahan declares that he has no conflict of interest. The author Mikail Inal declares that he has no conflict of interest.

Ethical approval

This study is retrospective. Ethics committee approval was obtained from Kırıkkale University Non-invasive Research Ethics Committee (Date: 24.10.2018, Number: 2018.10.15).

Informed consent

There is no need to take informed consent, because the data were evaluated retrospectively.

Supplementary material

405_2019_5284_MOESM1_ESM.pdf (423 kb)
Supplementary material 1 (PDF 422 KB)
405_2019_5284_MOESM2_ESM.pdf (757 kb)
Supplementary material 2 (PDF 757 KB)


  1. 1.
    Stammberger HR, Kennedy DW, Anatomic Terminology Group (1995) Paranasal sinuses:anatomic terminology and nomenclature. Ann Otol Rhinol Laryngol Suppl 167:7–16CrossRefGoogle Scholar
  2. 2.
    Lim CC, Dillon WP, McDermott MW (1999) Mucocele involving the anterior clinoid process: MR and CT findings. AJNR Am J Neuroradiol 20:287–290Google Scholar
  3. 3.
    Thimmaiah VT, Anupama C (2017) Pneumatization patterns of onodi cell on multidetector computed tomography. J Oral Maxillofac Radiol 5(3):63–66CrossRefGoogle Scholar
  4. 4.
    Ozturan O, Yenigun A, Degirmenci N, Aksoy F, Veyseller B (2013) Co-existence of the Onodi cell with the variation of perisphenoidalstructures. Eur Arch Otorhinolaryngol 270:2057–2063CrossRefGoogle Scholar
  5. 5.
    Chee E, Looi A (2009) Onodi sinusitis presenting with orbital apexsyndrome. Orbit 28:422–424CrossRefGoogle Scholar
  6. 6.
    Deshmukh S, DeMonte F (2007) Anterior clinoidal mucocele causingoptic neuropathy: resolution with nonsurgical therapy: case report. J Neurosurg 106:1091–1093CrossRefGoogle Scholar
  7. 7.
    Klink T, Pahnke J, Hoppe F, Lieb W (2000) Acute visual loss by an Onodi cell. Br J Ophthalmol 84:801–802CrossRefGoogle Scholar
  8. 8.
    Chmielik A, Chmielik L, Boguslawska-Walecka R, Warszawa PL, Warsaw PL (2014) The prevalence and CT detection of Onodi cell types. ECR 2014 Congress, poster no: C-1566. Accessed 26 Oct 2018
  9. 9.
    Chmielik L, Chmielik A (2017) The prevalence of the Onodi cell—most suitable method of CT evaluation in its detection. Int J Pediatr Otorhinolaryngol 97:202–205CrossRefGoogle Scholar
  10. 10.
    Metson R, Gliklich RE, Stankiewicz JA et al (1997) Comparison of sinus computed tomography staging systems. Otolaryngol Head Neck Surg 117(4):372–379CrossRefGoogle Scholar
  11. 11.
    Senturk M, Guler I, Azgin I et al (2017) The role of Onodi cells in sphenoiditis: results of multiplanar reconstruction of computed tomography scanning. Braz J Otorhinolaryngol 83:88–93CrossRefGoogle Scholar
  12. 12.
    Bilici S, Huq GE, Sunter AV, Yigit O, Yildiz M (2014) Onodi cell mucocele: case report. Otolaryngology 4–4Google Scholar
  13. 13.
    Kim JY, Kim HJ, Kim CH, Lee JG, Yoon JH (2005) Optic nerve injury secondary to endoscopic sinus surgery: an analysis of three cases. Yonsei Med J 46(2):300–304CrossRefGoogle Scholar
  14. 14.
    Driben JS, Bolger WE, Robles HA, Cable B, Zinreich SJ (1998) The reliability of computerized tomographic detection of the Onodi (sphenoethmoid) cell. Am J Rhinol 12:105–111CrossRefGoogle Scholar
  15. 15.
    Weinberger DG, Anand VK, Al-Rawi M, Cheng HI, Messina AV (1996) Surgical anatomy and variations of the Onodi cell. Am J Rhinol 10:365–370CrossRefGoogle Scholar
  16. 16.
    Nitinavakarn B, Thanaviratananich S, Sangsilp N (2005) Anatomical variations of the lateral nasal wall and paranasal sinuses: a CT study for endoscopic sinus surgery (ESS) in Thai patients. J Med Assoc Thai 88:763–768Google Scholar
  17. 17.
    Unal B, Bademci G, Bilgili YK, Batay F, Avci E (2006) Risky anatomic variations of sphenoid sinus for surgery. Surg Radiol Anat 28:195–201CrossRefGoogle Scholar
  18. 18.
    Arslan H, Aydinlioğlu A, Bozkurt M, Egeli E (1999) Anatomic variations of the paranasal sinuses: CT examination for endoscopic sinus surgery. Auris Nasus Larynx 26:39–48CrossRefGoogle Scholar
  19. 19.
    Nomura K, Nakayama T, Asaka D et al (2013) Laterally attached superior turbinate is associated with opacification of the sphenoid sinus. Auris Nasus Larynx 40:194–198CrossRefGoogle Scholar
  20. 20.
    De Lano MC, Fun FY, Zinreich SJ (1996) Relationship of the optic nerve to the posterior paranasal sinuses: a CT anatomic study. Am J Neuroradiol 17(4):669–675Google Scholar
  21. 21.
    Yeoh KH, Tan KK (1994) The optic nerve in the posterior ethmoid in Asians. Acta Otolaryngol 114(3):329–336CrossRefGoogle Scholar
  22. 22.
    Dessi I, Moulin G, Castro F, Chagnaud C, Cannoni M (1994) Protrusion of the optic nerve into the ethmoid and sphenoid sinus: prospective study of 150 CT studies. Neuroradiology 36:515–516CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Radiology Department, Faculty of MedicineKırıkkale UniversityKırıkkaleTurkey
  2. 2.ENT Department, Faculty of MedicineKırıkkale UniversityKırıkkaleTurkey
  3. 3.Birlik MahallesiAnkaraTurkey

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