Anatomy Of Paranasal Sinuses

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Anatomy Of Paranasal Sinuses

  1. 1. ANATOMY OF PARANASAL SINUSES PRATYUSH KUMAR
  2. 2. objectives <ul><li>To know anatomical location </li></ul><ul><li>Their connections & significance </li></ul><ul><li>Development </li></ul><ul><li>Neurovascular supply </li></ul><ul><li>Applied anatomy </li></ul>
  3. 3. Introduction <ul><li>Air containing cavities. </li></ul><ul><li>Each sinus are named after the bone it resides in. </li></ul><ul><li>4 pairs :- </li></ul><ul><li>frontal </li></ul><ul><li>maxillary, ethmoidal, sphenoidal </li></ul>
  4. 4. Anterior and lateral view
  5. 6. Maxillary sinuses <ul><li>Largest pns </li></ul><ul><li>Pyramidal in shape, </li></ul><ul><li>base pointing to lateral wall of nose </li></ul><ul><li>Apex laterally in the zygomatic process </li></ul><ul><li>Capacity 15 ml </li></ul>
  6. 7. Relations <ul><li>Anterior:- facial surface of maxilla </li></ul><ul><li>Posterior:-infratemporal and pterygopalatine fossa </li></ul><ul><li>Medial:- middle and inferor meatus </li></ul><ul><li>Floor:- alveolar and palatine processes of maxilla </li></ul><ul><li>Roof:-floor of orbit </li></ul>
  7. 8. <ul><li>Blood supply : Facial, infra orbital, greater palatine arteries. </li></ul><ul><li>Lymphatic drainage : Submandibular nodes. </li></ul><ul><li>Nerve supply : Infra orbital, anterior, middle and post superior alveolar nerves. </li></ul>
  8. 9. Frontal sinus <ul><li>Resides in frontal bone </li></ul><ul><li>2 nd largest </li></ul><ul><li>Asymmetrical </li></ul><ul><li>Usually paired -sometimes one, three or none! </li></ul>
  9. 10. Relations <ul><li>Anterior:- skin over the forehead </li></ul><ul><li>Inferior:-orbit & its contents </li></ul><ul><li>Posterior:- meningeal and frontal lobe of brain </li></ul>
  10. 11. Neurovascular supply <ul><li>Blood supply - Supra orbital artery Anterior ethmoidal arteries. </li></ul><ul><li>Venous return - Anastomotic veins in supra orbital notch, connecting supra orbital and supra ophthalmic veins. </li></ul><ul><li>  Lymphatic drainage - Submandibular nodes. </li></ul><ul><li>Nerve supply - Supra orbital nerve traversing the floor of the sinus. </li></ul>
  11. 12. Ethmoidal sinuses <ul><li>Resides in ethmoid bone </li></ul><ul><li>3 groups:- anterior , posterior , sphenoethmoidal recess </li></ul><ul><li>Number varies from 3-18 </li></ul><ul><li>Present from birth </li></ul>
  12. 13. Relation <ul><li>Roof:- anterior cranial fossa </li></ul><ul><li>Lateral:- orbit (separated by lamina papyracea) </li></ul><ul><li>Optic nerve lies close to posterior ethmoidal cells </li></ul>
  13. 14. Neurovascular supply <ul><li>Blood supply : Sphenopalatine artery  Anterior and posterior ethmoidal artery. </li></ul><ul><li>Lymphatic drainage : Submandibular nodes Retropharyngeal nodes.  </li></ul><ul><li>Nerves : Anterior and posterior ethmoidal nerves. Orbital branches of pterygopalatine ganglion.. </li></ul>
  14. 15. Sphenoid sinus <ul><li>Resides in body of sphenoid </li></ul><ul><li>Maybe single or paired </li></ul><ul><li>Asymmetrical </li></ul><ul><li>Not present at birth </li></ul>
  15. 16. Relation <ul><li>Lies below to sella turcica </li></ul><ul><li>Sphenoid effusion shows skull base fracture </li></ul><ul><li>Related to optic tract,chiasma, internal carotid artery </li></ul>
  16. 17. <ul><li>Blood supply : Posterior ethmoidal artery. </li></ul><ul><li>Lymphatic drainage : Retropharyngeal nodes. </li></ul><ul><li>Nerve supply : Posterior ethmoidal nerve. </li></ul>
  17. 18. Microscopic anatomy <ul><li>Lined by mucus membrane </li></ul><ul><li>Ciliated columnar epithelium </li></ul><ul><li>goblet cells secretes mucus </li></ul><ul><li>Cilia are more marked near ostia. </li></ul>
  18. 19. Development <ul><li>Outpouching from mucus membrane of nose </li></ul><ul><li>at birth:-Maxillary and ethmoidal present </li></ul><ul><li>At 6-7 yrs:- frontals and sphenoids </li></ul><ul><li>At 17-18 :- all full developed </li></ul>
  19. 21. Drainage

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