[Does Onodi cell limit the exposure of sella during transsphenoidal pituitary surgery?].
OBJECTIVE
This study aims to evaluate the association between the presence of Onodi cell and sella exposure during endonasal endoscopic transsphenoidal pituitary surgery (EETPS).


METHODS
Forty-two patients who underwent EETPS for a pituitary adenoma with the collaboration of Neurosurgery and Otorhinolaryngology Departments at Katip Çelebi University Atatürk Training and Research Hospital between February 2011 and March 2014 were retrospectively analyzed. Preoperative paranasal sinus tomography and intraoperative findings were evaluated for the presence of Onodi cells. The location of the Onodi cell and its relation with sella exposure during surgery were also assessed.


RESULTS
The incidence of Onodi cell was 19%. The Onodi cells were observed in eight of 42 patients on preoperative paranasal sinus computed tomography. The Onodi cells were unilateral in five patients and bilateral in three. Intraoperative findings were correlated with tomographic findings. In seven patients, Onodi cells limited the exposure of sellar floor and the inferior-medial wall of these cells were removed and connected with the sphenoid sinus and the entire sellar floor was exposed. In the remaining one patient, the Onodi cell was smaller and located superolaterally. This cell was not removed, as it did not limited the sellar exposure.


CONCLUSIONS
The Onodi cell may limit the sella exposure during transsphenoidal surgery. Onodi cell should be removed and connected with the sphenoid sinus cavity for the entire sellar floor exposure.
Department of Otolaryngology, Katip Çelebi University, Atatürk Training and Research Hospital, 35360 Basın Sitesi, İzmir, Turkey. kadir_imre@yahoo.com.
Abdulkadir
A
İmre
Ercan
E
Pinar
Nurullah
N
Yüceer
Murat
M
Songu
Yüksel
Y
Olgun
İbrahim
İ
Aladağ
D000236:Adenoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013506:Otologic Surgical Procedures / Q000379:methods*; D010911:Pituitary Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012658:Sella Turcica / Q000473:pathology / Q000601:surgery*; D013101:Sphenoid Sinus; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome