Blinding Orbital Apex Syndrome due to Onodi Cell Mucocele

Fleissig, Efrat; Spierer, Oriel; Koren, Ilan; Leibovitch, Igal

doi:10.1155/2014/453789

Cited by 9 publications

(7 citation statements)

References 5 publications

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“…Improvement was usually seen within a week or two, occasionally up to a month according to the timing of surgical intervention. [10–12] Unlike previous reports, the course in our patient was much delayed by more than 4 months until complete recovery. Considering early surgical intervention (5 days after the onset of vertical diplopia), further studies are needed to determine the time course of neural recovery after surgical decompression.…”

Section: Discussioncontrasting

confidence: 77%

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Onodi cell mucocele causing isolated trochlear nerve palsy

Kwon

Kim

et al. 2019

Medicine

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Rationale: Acquired vertical diplopia is commonly observed in trochlear nerve palsy, often resulting from blunt head trauma or vascular problems. It is rarely caused by tumorous conditions or space occupying lesion. We report the first case of Onodi cell mucocele causing isolated trochlear nerve palsy. Patient concerns: A 62-year-old male noticed a double vision which worsened when looking down. On ophthalmologic examinations, the patient showed no abnormalities in visual acuity, intraocular pressure, and no swelling in optic disc. In ocular motility test, he was notable for 10° left hypertropia in primary position, 6° in right head tilt position, 14° in left head tilt position and this was aggravated in right and down gaze. Ostiomeatal complex CT depicted an expansile soft tissue density completely filling the left Onodi cell. Diagnoses: He was diagnosed with a trochlear nerve palsy caused by an isolated mucocele in the left Onodi cell. Interventions: Three days after presentation, he underwent endoscopic sinus surgery for marsupialization of the mucocele in the left Onodi cell. Outcomes: The mucocele was completely removed through the endoscopic endonasal approach. Within 4 months after surgery, his 4th nerve palsy had gradually and completely improved. Lessons: Onodi cell mucoceles that cause trochlear nerve palsy are extremely rare. Timely surgical decompression is essential to achieve optimal recovery of the neural function. Combined trochlear nerve palsy should be evaluated when Onodi cell mucocele involves the orbital apex from above.

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Section: Discussioncontrasting

confidence: 77%

“…Early intervention is very critical in recovery of neural function. [9,10] Controversy is still existed regarding postoperative recovery time after ocular motor nerve decompression. Improvement was usually seen within a week or two, occasionally up to a month according to the timing of surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

Onodi cell mucocele causing isolated trochlear nerve palsy

Kwon

Kim

et al. 2019

Medicine

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“…The microbiology of these complications differs from that of ARS 1299 . Direct extension of RS into the orbit or chronic inflammatory changes near the orbit may begin with minor signs (eg, preseptal cellulitis) but can rapidly lead to orbital cellulitis/abscess causing enophthalmos, 1300 epiphora, 1301 diplopia, 1302 proptosis, 1303 optic neuropathy 1304,1305 and vision loss 1306–1308 . A recent study reported increased risk of orbital complications in adults, specifically in patients with previous sinus surgery or dehiscence of the lamina papyracea 464 .…”

Section: Chronic Rhinosinusitis Without Nasal Polyps (Crssnp)mentioning

confidence: 99%

International consensus statement on allergy and rhinology: rhinosinusitis 2021

Orlandi

Kingdom

Smith

et al. 2021

Int Forum Allergy Rhinol

481

479

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I. Executive Summary Background The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS.

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“…825 Direct involvement or chronic inflammatory changes near the orbit can lead to enophthalmos, 826 epiphora, 827 diplopia, 828 proptosis, 829 optic neuropathy, 830,831 and vision loss. [832][833][834] Fungal or bacterial invasion along the skull base can lead to an epidural abscess or cavernous sinus thrombosis. The chronic inflammatory response observed in CRS can worsen existing airway hyperreactivity, but it can also lead to adult-onset asthma.…”

Section: Viif Crssnp: Complicationsmentioning

confidence: 99%

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

554

888

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Background:The body of knowledge regarding rhinosinusitis (RS) continues to expand, with rapid growth in number of publications, yet substantial variability in the quality of those presentations. In an effort to both consolidate and critically appraise this information, rhinologic experts from around the world have produced the International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR:RS). Methods:Evidence-based reviews with recommendations (EBRRs) were developed for scores of topics, using previously reported methodology. Where existing evidence was insufficient for an EBRR, an evidence-based review (EBR) was produced. The sections were then synthesized and the entire manuscript was then reviewed by all authors for consensus. Results:The resulting ICAR:RS document addresses multiple topics in RS, including acute RS (ARS), chronic RS (CRS) with and without nasal polyps (CRSwNP and CRSsNP), recurrent acute RS (RARS), acute exacerbation of CRS (AE-CRS), and pediatric RS. Conclusion:As a critical review of the RS literature, ICAR:RS provides a thorough review of pathophysiology and evidence-based recommendations for medical and surgical treatment. It also demonstrates the significant gaps in our understanding of the pathophysiology and optimal management of RS. Too o en the foundation upon which these recommendations are based is comprised of lowerlevel evidence. It is our hope that this summary of the evidence in RS will point out where additional research efforts may be directed. C 2016 ARS-AAOA, LLC. Key Words:rhinosinusitis; chronic rhinosinusitis; acute rhinosinusitis; recurrent acute rhinosinusitis; evidence-based medicine; systematic review; endoscopic sinus surgery List of Abbreviations Used

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Blinding Orbital Apex Syndrome due to Onodi Cell Mucocele

Cited by 9 publications

References 5 publications

Onodi cell mucocele causing isolated trochlear nerve palsy

Onodi cell mucocele causing isolated trochlear nerve palsy

International consensus statement on allergy and rhinology: rhinosinusitis 2021

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

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