Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May 16;14(10):3508.
doi: 10.3390/jcm14103508.

Do Onodi Cells Influence the Onset of Sphenoiditis? A Multicentric Cross-Sectional Study

Gian Luca Fadda  1 , Alberto Maria Saibene  2 , Chiara Rustichelli  1 , Letizia Nitro  3 , Mario Lentini  4 , Federica Maria Parisi  5 , Salvatore Cocuzza  5 , Giovanni Cavallo  1 , Eugenio De Corso  6 , Antonino Maniaci  4   7
Affiliations

Do Onodi Cells Influence the Onset of Sphenoiditis? A Multicentric Cross-Sectional Study

Gian Luca Fadda et al. J Clin Med. .

Abstract

Background: Sphenoiditis poses diagnostic and treatment challenges due to its complex anatomy and potential for serious complications. Anatomic variations, such as Onodi cells, could play a role in the onset and spreading of inflammation. The diagnosis and treatment of sphenoiditis can be more difficult if Onodi cells are present, especially due to their proximity to delicate vital tissues. Objectives: The purpose of this study was to look at the frequency, features, and relationship between Onodi cells and sphenoiditis. Methods: This multicentric study comprised 550 people who received sinonasal CT imaging. The Thimmaiah classification was used to assess the presence and features of Onodi cells, and radiographic results were used to diagnose sphenoiditis. We conducted univariate and multivariate logistic regression to evaluate the relationships between sphenoiditis and Onodi cells. Results: The prevalence of Onodi cells was 32.40%, with a higher prevalence on the right side (18.40%) compared to the left side (8.40%). The multivariable analysis revealed a significant correlation between right-side Type II Onodi cells and a higher incidence of sphenoiditis (OR = 6.81, 95% CI: 1.14-38.97, p = 0.029). In the univariable analysis (OR = 3.00, 95% CI: 1.15-6.96, p = 0.015), but not in the multivariable analysis, the presence of Type I Onodi cells on the left side was significantly associated with sphenoiditis. Conclusions: There may be a link between a higher incidence of sphenoiditis and the presence of Type II Onodi cells on the right side. In order to validate these findings and clarify the underlying processes of this connection, more prospective research is required.

Keywords: Onodi cells; anatomical landmarks; paranasal sinuses; sphenoiditis; tomography.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Flowchart study protocol.
Figure 2
Figure 2
Coronal PNS CT scans. (a) Onodi cell (*) type I pattern of pneumatization is above and medial the horizontal line. (b) Onodi cell (*) type II is above and below the horizontal line. (c) Onodi cell (*) type III is below the horizontal line. A horizontal line was drawn at the uppermost part of sphenoid sinus (s) in the coronal image. Optic canals (white arrows) with bulging > 5 mm (type 4) are shown [30,31].
Figure 3
Figure 3
PNS CT imaging showing correlation between Type II Onodi cell and right-sided sphenoiditis. (a) Coronal, (b) sagittal and (c) axial PNS CT scan showing type II Onodi cell (asterisk) extending superolaterally from the sphenoid sinus, and sphenoiditis with complete opacification of the right sphenoid sinus (s) and optic canals (white arrow); (d) endoscopic right sphenoid sinus (s) and Onodi cell (asterisk) are shown.
Figure 4
Figure 4
PNS CT and endoscopic images showing correlation between Type II Onodi cell and left-sided sphenoiditis. (a) Coronal PNS CT images showing Type II Onodi cell (asterisk) with superolateral extension and a complete opacification of the left sphenoid sinus. Note the proximity to the optic canal (white arrow), highlighting the clinical significance of this anatomical variation. (b) Endoscopic view of the left sphenoid sinus (s), showing the inflamed Onodi cell (asterisk) with purulent discharge visible at the ostium.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Onodi A. Der Sehnerv and Die NebenOhlen der Nase. Alfred Holder; Wien, Germany: 1907. The optic nerve and the accessory sinuses of the nose; pp. 1–6.
    1. Fadda G.L., Petrelli A., Urbanelli A., Castelnuovo P., Bignami M., Crosetti E., Succo G., Cavallo G. Risky anatomical variations of sphenoid sinus and surrounding structures in endoscopic sinus surgery. Head Face Med. 2022;18:29. doi: 10.1186/s13005-022-00336-z. - DOI - PMC - PubMed
    1. Özdemir A., Bayar Muluk N., Asal N., Şahan M.H., Inal M. Is there a relationship between Onodi cell and optic canal? Eur. Arch. Otorhinolaryngol. 2019;276:1057–1064. doi: 10.1007/s00405-019-05284-0. - DOI - PubMed
    1. Ali I.K., Sansare K., Karjodkar F., Saalim M. Imaging Analysis of Onodi Cells on Cone-Beam Computed Tomography. Int. Arch. Otorhinolaryngol. 2020;24:e319–e322. doi: 10.1055/s-0039-1698779. - DOI - PMC - PubMed
    1. Chipczyńska B., Kosowski H., Skrzat J. Sphenoid sinus and sphenoid bone fractures in patients with isolated orbital injuries. Med. Sci. Monit. 2016;22:4327–4332.