A case of Dr. André Felippu
Onodi's cell is a rare and complex anatomical structure located in the posterior ethmoid sinus, which may be closely related to the optic nerve and the maxillary nerve (V2). In this article, we present an endoscopic surgery performed by the Onodi cell. Dr. André Felippu, a rhinology specialist, who addresses a case of sphenoid mucocele using traditional endoscopic transnasal access. This procedure is available at our SurgSchool surgical training app.
Clinical Case: Patient with Headache and Nasal Distortion
The patient, a man with a two-year history of nonspecific headache in the left occipital region, came to the clinic with a nasal distortion. A CT scan revealed a lesion compatible with a mucocele in the left sphenoid sinus, more specifically within an Onodi cell. This lesion was located close to the optic nerve and the maxillary nerve (V2), which further complicated the surgical approach.
Surgical Approach: Access to the Sphenoid Sinus and Onodi Cell
El Dr. Felippu decided to perform a minimally invasive transnasal approach. Initially, the natural ostium of the left sphenoid sinus was identified. To improve access, the ostium was enlarged using osteotomes and chisels, allowing for greater visibility and maneuverability within the sphenoid sinus.
With the aid of an angled optic, the surgical team was able to visualize both the lower portion of the lesion and adjacent structures such as the vidian nerve and the pterygoid recess of the sphenoid sinus. The Onodi cell was then opened using a scalpel, allowing drainage of the secretion accumulated within the mucocele.
Mucocele Removal and Final Results
The resection of the bony portion surrounding the Onodi cell was performed with precision, using a vacuum to remove the accumulated pus and secretions. This intervention relieved the patient's pressure and headache. With an additional angled optic, Dr. Felippu was able to access a cyst close to the optic nerve, which was also removed for pathological analysis.
The final result was a completely open and drained Onodi cell, ensuring adequate flow of secretions and minimizing the risk of recurrence.
Learn from the Best at SurgSchool
This procedure performed by Dr. André Felippu is an excellent example of how advanced nasal endoscopy can offer effective solutions for complex cases. SurgSchool gives you the opportunity to see this and many other surgeries performed by international expertsOur platform offers high-quality videos in 4K and FullHD, designed to provide an immersive learning experience to otolaryngologists around the world.
