Nose and paranasal sinuses: Onodi cell: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Nose and paranasal sinuses: Onodi cell

Sample item

A surgeon preparing for sphenoid sinus surgery notes a posterior ethmoid cell that extends superolaterally to the sphenoid sinus in contact with the optic nerve. What is the surgical risk?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Optic nerve injury with visual loss, as in an Onodi cell

The Onodi (sphenoethmoidal) cell is a posterior ethmoid cell that pneumatises lateral or superior to the sphenoid sinus, putting the optic nerve and sometimes the carotid artery in its wall. Misidentifying it as the sphenoid may cause blindness. CT is essential before surgery.

Option by option

  • A. Epiphora

    Epiphora results from lacrimal injury.

  • B. Optic nerve injury with visual loss, as in an Onodi cell (correct)

    Correct. The optic nerve lies in its lateral wall.

  • C. Facial nerve palsy

    The facial nerve is not at risk in nasal surgery.

  • D. Anosmia from cribriform injury

    Anosmia would follow injury to the cribriform plate.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is B, Optic nerve injury with visual loss, as in an Onodi cell. The Onodi (sphenoethmoidal) cell is a posterior ethmoid cell that pneumatises lateral or superior to the sphenoid sinus, putting the optic nerve and sometimes the carotid artery in its wall.

Why is "Epiphora" not the answer?

Epiphora results from lacrimal injury.

Why is "Facial nerve palsy" not the answer?

The facial nerve is not at risk in nasal surgery.

Why is "Anosmia from cribriform injury" not the answer?

Anosmia would follow injury to the cribriform plate.

What concept does this question test?

It tests Nose and paranasal sinuses: Onodi cell in ENT. Misidentifying it as the sphenoid may cause blindness. CT is essential before surgery.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Nose and paranasal sinuses: Onodi cell?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.