This document provides an overview of the anatomy of the paranasal sinuses. It discusses the four main sinuses - maxillary, frontal, ethmoid, and sphenoid sinuses. For each sinus it describes the location, size, drainage pathways, blood supply, nerve supply, clinical importance and key anatomical relationships. The ethmoid sinus is noted to be the most variable with 3-18 cells on each side that can pneumatize into surrounding bones. Understanding the anatomy of the paranasal sinuses is important for sinus surgery and procedures.
The nose and paranasal sinuses develop from the frontonasal process. The nose has external and internal structures. Externally, cartilage and bone provide structure, while internally the nasal cavities contain three turbinates and three meatuses on each side. The paranasal sinuses include the frontal, ethmoid, maxillary, and sphenoid sinuses. The sinuses are lined with ciliated respiratory epithelium and contain ostia that drain into the nasal cavities. The nose and sinuses receive blood supply from the external and internal carotid arteries and are innervated by branches of the trigeminal and facial nerves. Lymphatic drainage occurs to local cervical nodes.
The document discusses the anatomy and development of the nose and paranasal sinuses. It describes how the nose develops from embryonic structures and the formation of the nasal cavity, septum, and external nose. It then covers the anatomy of the different areas of the nose in detail, including the vestibule, muscles, bones/cartilages, blood supply, nerves and lymphatic drainage. Finally, it discusses the anatomy of each paranasal sinus, including the sphenoid sinus and its variations in pneumatization.
The paranasal sinuses are air-filled spaces in the skull bones surrounding the nose. There are four main paranasal sinuses: the frontal sinuses, ethmoidal sinuses, maxillary sinus, and sphenoid sinus. The paranasal sinuses lighten the skull, increase voice resonance, and act as cushions protecting the brain, eyes, and pituitary gland. The sinuses develop after birth and increase in size with the eruption of permanent teeth.
The middle ear cavity is located between the tympanic membrane and inner ear. It contains the auditory ossicles (malleus, incus, stapes), muscles (tensor tympani, stapedius), and is connected to the nasopharynx via the Eustachian tube. The cavity has thin bony walls that separate it from important structures like the cranial fossa and carotid artery. The ossicles transmit sound vibrations from the tympanic membrane to the inner ear.
The document provides details on the anatomy of the middle ear, including its walls, structures, and measurements. Key points:
- The middle ear is an air-filled cavity in the temporal bone between the external ear canal and inner ear. It is divided into three regions and contains the ossicles, muscles, and facial nerve.
- The walls of the middle ear cavity include the lateral, inferior, posterior, superior, anterior, and medial walls. Important structures on the walls include the tympanic membrane, ossicles, facial nerve canal, oval and round windows.
- The middle ear cavity measures approximately 2mm wide at its center, widening to 6mm superiorly and 4mm inferiorly.
The document summarizes the anatomy of the salivary glands. It describes the locations and relations of the major salivary glands: the parotid gland is the largest salivary gland located in the preauricular region, the submandibular gland is inferior to the mandible, and the sublingual gland is beneath the floor of the mouth. It also discusses the minor salivary glands distributed in the oral mucosa, and the innervation and blood supply of the major salivary glands.
This document provides an overview of the anatomy of the paranasal sinuses. It discusses the four main sinuses - maxillary, frontal, ethmoid, and sphenoid sinuses. For each sinus it describes the location, size, drainage pathways, blood supply, nerve supply, clinical importance and key anatomical relationships. The ethmoid sinus is noted to be the most variable with 3-18 cells on each side that can pneumatize into surrounding bones. Understanding the anatomy of the paranasal sinuses is important for sinus surgery and procedures.
The nose and paranasal sinuses develop from the frontonasal process. The nose has external and internal structures. Externally, cartilage and bone provide structure, while internally the nasal cavities contain three turbinates and three meatuses on each side. The paranasal sinuses include the frontal, ethmoid, maxillary, and sphenoid sinuses. The sinuses are lined with ciliated respiratory epithelium and contain ostia that drain into the nasal cavities. The nose and sinuses receive blood supply from the external and internal carotid arteries and are innervated by branches of the trigeminal and facial nerves. Lymphatic drainage occurs to local cervical nodes.
The document discusses the anatomy and development of the nose and paranasal sinuses. It describes how the nose develops from embryonic structures and the formation of the nasal cavity, septum, and external nose. It then covers the anatomy of the different areas of the nose in detail, including the vestibule, muscles, bones/cartilages, blood supply, nerves and lymphatic drainage. Finally, it discusses the anatomy of each paranasal sinus, including the sphenoid sinus and its variations in pneumatization.
The paranasal sinuses are air-filled spaces in the skull bones surrounding the nose. There are four main paranasal sinuses: the frontal sinuses, ethmoidal sinuses, maxillary sinus, and sphenoid sinus. The paranasal sinuses lighten the skull, increase voice resonance, and act as cushions protecting the brain, eyes, and pituitary gland. The sinuses develop after birth and increase in size with the eruption of permanent teeth.
The middle ear cavity is located between the tympanic membrane and inner ear. It contains the auditory ossicles (malleus, incus, stapes), muscles (tensor tympani, stapedius), and is connected to the nasopharynx via the Eustachian tube. The cavity has thin bony walls that separate it from important structures like the cranial fossa and carotid artery. The ossicles transmit sound vibrations from the tympanic membrane to the inner ear.
The document provides details on the anatomy of the middle ear, including its walls, structures, and measurements. Key points:
- The middle ear is an air-filled cavity in the temporal bone between the external ear canal and inner ear. It is divided into three regions and contains the ossicles, muscles, and facial nerve.
- The walls of the middle ear cavity include the lateral, inferior, posterior, superior, anterior, and medial walls. Important structures on the walls include the tympanic membrane, ossicles, facial nerve canal, oval and round windows.
- The middle ear cavity measures approximately 2mm wide at its center, widening to 6mm superiorly and 4mm inferiorly.
The document summarizes the anatomy of the salivary glands. It describes the locations and relations of the major salivary glands: the parotid gland is the largest salivary gland located in the preauricular region, the submandibular gland is inferior to the mandible, and the sublingual gland is beneath the floor of the mouth. It also discusses the minor salivary glands distributed in the oral mucosa, and the innervation and blood supply of the major salivary glands.
Imaging of paranasal sinuses (including anatomy and varaints)pk1 pdf pptDr pradeep Kumar
This is very good powerpoint presentation of imaging anatomy and variants of paranasal sinuses and imaging pathology as well as multiple pathological imaging findings and images.it will helps for radiologist and radiology resident and even ent resident. our references is CT and mri whole body by Haaga and various internet sources. THANKS.
This document provides an overview of the paranasal sinuses, describing their anatomy and locations. It divides the paranasal sinuses into two groups: the anterior group including the maxillary, frontal, and anterior ethmoidal sinuses; and the posterior group containing the posterior ethmoidal and sphenoid sinuses. Details are given on the maxillary sinus as the largest sinus, including its pyramidal shape, measurements, and relations to surrounding structures. Information is also provided on the frontal sinus, its triangular shape and potential asymmetry between sides.
Anatomy of oropharynx maxilla mandible neck nodesSamik Sharma
This document provides an overview of the anatomy of the oropharynx and maxilla. It discusses the structures that make up the oropharynx, including the tongue, tonsils, soft palate and walls. It notes the oropharynx's roles in swallowing and speech and that it is a common site for head and neck tumors. The document then provides details on the development, bones, fossae, processes, sinuses and articulations of the maxilla. It discusses the maxilla's role in forming parts of the oral cavity, nose and orbit. Finally, it provides an in-depth overview of the anatomy and development of the mandible, including its parts, muscles and blood supply.
The document provides details on the anatomy and development of the paranasal sinuses. It discusses the ossification and development of the bones that form the sinuses, including the maxilla, ethmoid, frontal, and sphenoid bones. For each sinus, it describes the location, size, drainage pathways, blood supply, nerve innervation, and key relationships to surrounding structures. The maxillary sinus is the largest sinus and develops from the lateral nasal wall. The ethmoid sinuses develop within the ethmoid bone and include multiple air cells. The frontal and sphenoid sinuses have more variable development and anatomy.
The document discusses the anatomy and variants of the paranasal sinuses relevant to functional endoscopic sinus surgery (FESS). It describes the four paired sinuses and their drainage pathways. Key anatomical structures for drainage include the osteomeatal complex and frontal recess. Common anatomic variants are described such as concha bullosa, Haller cells, and Onodi cells which can impact sinus drainage. Radiologists should evaluate pre-operative scans for variants that may obstruct drainage or pose surgical hazards. A systematic checklist is recommended to identify issues important for surgical planning.
ANATOMY OF MID EAR and related structures.pptxJitenLad2
The middle ear consists of the tympanic cavity, Eustachian tube, and mastoid air cell system. The tympanic cavity contains the ossicles and is bounded by walls that form compartments. It communicates with the nasopharynx via the Eustachian tube and with the mastoid antrum. The mastoid antrum leads to extensive air cells within the temporal bone. Structures like the facial nerve canal pass through the walls and roof of the middle ear.
This document provides an overview of the anatomy of the paranasal sinuses. There are four paired paranasal sinuses located in the skull bones surrounding the nasal cavity: the maxillary, frontal, ethmoid, and sphenoid sinuses. Each sinus has thin bony walls and is lined with mucous membrane continuous with the nasal cavity. The maxillary sinus is the largest sinus, located within the body of the maxilla bone. The ethmoid sinuses are numerous air cells located within the ethmoid bone between the orbit and nasal cavity. The frontal sinus is located within the frontal bone above the orbit, while the sphenoid sinus occupies the sphenoid bone behind the ethmoid labyrinth.
The document discusses the anatomy and imaging of the paranasal sinuses. It begins with the embryology of the sinuses, noting that the maxillary, ethmoid, and frontal sinuses develop from invaginations of the nasal cavity into bones. The anatomy sections describe each of the four major sinuses - maxillary, ethmoid, sphenoid, and frontal - as well as other structures like the osteomeatal complex and nasal passages. Variations in anatomy are also covered. Imaging modalities for evaluating the sinuses include conventional radiography, CT, and MRI, with CT considered the gold standard.
This document provides an overview of the paranasal sinuses. It discusses the development, anatomy, and functions of the frontal, ethmoidal, sphenoidal, and maxillary sinuses. It describes their development from diverticulae of the nasal cavity walls. The maxillary sinus is the largest sinus and develops earlier than the others. Clinical considerations include sinusitis, tumors, oroantral fistulas, and sinus lift procedures to augment bone for dental implants.
1. The nose is divided into an external pyramidal part made of bone and cartilage, and an internal nasal cavity divided by the nasal septum.
2. The external nose contains upper lateral, lower alar, and septal cartilages that provide structural support. The internal nasal cavity contains three turbinates that project from the walls.
3. The nasal cavity is divided into the anterior vestibule lined by skin and the mucosa-lined nasal cavity proper containing the olfactory region and respiratory region with pseudostratified epithelium. Various structures like the uncinate process and bulla ethmoidalis are related to sinus drainage and surgery.
The nose develops from the frontonasal process and surrounding structures in the embryo. It has bony and cartilaginous components that provide structure. The nasal cavities contain three turbinates and three meatuses for drainage. The paranasal sinuses develop later in life and include the maxillary, ethmoid, frontal, and sphenoid sinuses. The sinuses are lined with mucous membrane and have ostia that drain into the meatuses. The nose has important functions including warming, humidifying, and filtering air as well as roles in smell and voice resonance.
The document provides an overview of the nose, paranasal sinuses, and ear. It describes the external nose, nasal cavity, and paranasal sinuses which include the maxillary, frontal, sphenoid, and ethmoid sinuses. It then discusses the external, middle, and inner ear. The middle ear contains the auditory ossicles and tympanic membrane, while the inner ear houses the organs of hearing and balance within the bony labyrinth.
The summary of the document is:
1. The nose and paranasal sinuses develop between 4-8 weeks of fetal life from the frontonasal process and maxillary processes.
2. By 5-6 weeks, nasal placodes form and invaginate to form nasal pits which later fuse to form the primitive nasal cavity.
3. Between 7-10 weeks, the paranasal sinuses begin to form from outpocketings of the nasal mucosa. The maxillary sinus is the first to form around 3 months of gestation.
4. The external nose is made up of bones, cartilages and overlying skin and muscle. The internal nasal cavity has
The document summarizes key information about the maxillary sinus, including its development, anatomy, blood supply, drainage, and clinical importance. It begins with a brief overview of paranasal sinuses and then focuses on the maxillary sinus. The maxillary sinus develops from the maxillary process by 12 weeks gestation and increases in size throughout childhood and adulthood. It has multiple walls that form its boundaries and drains into the middle meatus through the maxillary ostium. Issues like sinusitis, dental infections, and trauma can involve the maxillary sinus.
The document discusses the embryology, growth, development, anatomy and surgical anatomy of the maxilla bone. It begins with the embryological development of the maxilla from the first pharyngeal arch. It then describes the growth of the maxilla through mechanisms such as displacement, growth at sutures and surface remodeling. The anatomy section outlines the structures of the maxilla including its processes, surfaces and features such as the maxillary sinus and alveolar process.
The paranasal sinuses drain into specific areas of the nasal cavity. The frontal sinuses drain into the frontoethmoidal recess. The anterior ethmoid air cells drain into the anterior aspects of the hiatus semilunaris. The middle ethmoid air cells drain through the ethmoid bulla into the superior meatus. The maxillary sinus drains via the infundibulum into the maxillary ostium. The sphenoid sinus drains into the sphenoethmoid recess posterior to the superior meatus. Coronal CT is the preferred imaging modality to evaluate the paranasal sinuses and displays important anatomical landmarks like the maxillary sinus, turbinates, nasal septum, and unc
SEMINAR 13 - OAC AND OAF - introduction , surgical anatomy of maxillary sinus...Alex343664
This document discusses oro-antral communication/fistula, including its etiology, clinical presentation, and diagnosis. It begins with an introduction and overview. It then covers anatomy of the maxillary sinus, its physiology, and common causes of oro-antral communication and fistula. These include anatomical variations, dental factors like long roots or periapical pathology, and surgical procedures. Clinical presentation and diagnosis are also briefly mentioned. The document provides detailed information on maxillary sinus anatomy and factors involved in oro-antral communication formation.
The document summarizes the anatomy of the nose and paranasal sinuses. It describes the external nose, nasal cavity, paranasal sinuses, blood supply, nerve supply, and functions of the nose. The external nose has a bony and cartilaginous framework that provides structure. Internally, the nasal cavity is divided by the nasal septum and contains the paranasal sinuses which include the maxillary, frontal, ethmoid, and sphenoid sinuses. The nose functions include filtration, warming and humidifying air, olfaction, and vocal resonance.
Cross Sectional Anatomy of Paranasal sinus Sarbesh Tiwari
The document summarizes the anatomy and variations of the paranasal sinuses. It describes the locations and openings of the different sinus groups. Key anatomical structures involved in sinus drainage like the osteomeatal complex are also explained. Common anatomic variations seen on imaging that can affect sinus drainage are discussed. These variations include concha bullosa, Haller cells, Onodi cells and pneumatization of surrounding bones.
Anatomy of middle ear ..................SruthiNaren
The middle ear cavity is an air-filled space located in the temporal bone between the external auditory meatus and inner ear. It is divided into the mesotympanum, epitympanum, and hypotympanum. The middle ear has four walls - medial, lateral, anterior, and posterior - with a roof and floor. The lateral wall contains the tympanic membrane and bony structures like the tympanic ring, scutum, and tympanic spines. The posterior wall houses the facial nerve and contains structures like the pyramidal eminence and aditus ad antrum. The floor is narrow and separates the middle ear from nearby blood vessels and jugular bulb.
Imaging of paranasal sinuses (including anatomy and varaints)pk1 pdf pptDr pradeep Kumar
This is very good powerpoint presentation of imaging anatomy and variants of paranasal sinuses and imaging pathology as well as multiple pathological imaging findings and images.it will helps for radiologist and radiology resident and even ent resident. our references is CT and mri whole body by Haaga and various internet sources. THANKS.
This document provides an overview of the paranasal sinuses, describing their anatomy and locations. It divides the paranasal sinuses into two groups: the anterior group including the maxillary, frontal, and anterior ethmoidal sinuses; and the posterior group containing the posterior ethmoidal and sphenoid sinuses. Details are given on the maxillary sinus as the largest sinus, including its pyramidal shape, measurements, and relations to surrounding structures. Information is also provided on the frontal sinus, its triangular shape and potential asymmetry between sides.
Anatomy of oropharynx maxilla mandible neck nodesSamik Sharma
This document provides an overview of the anatomy of the oropharynx and maxilla. It discusses the structures that make up the oropharynx, including the tongue, tonsils, soft palate and walls. It notes the oropharynx's roles in swallowing and speech and that it is a common site for head and neck tumors. The document then provides details on the development, bones, fossae, processes, sinuses and articulations of the maxilla. It discusses the maxilla's role in forming parts of the oral cavity, nose and orbit. Finally, it provides an in-depth overview of the anatomy and development of the mandible, including its parts, muscles and blood supply.
The document provides details on the anatomy and development of the paranasal sinuses. It discusses the ossification and development of the bones that form the sinuses, including the maxilla, ethmoid, frontal, and sphenoid bones. For each sinus, it describes the location, size, drainage pathways, blood supply, nerve innervation, and key relationships to surrounding structures. The maxillary sinus is the largest sinus and develops from the lateral nasal wall. The ethmoid sinuses develop within the ethmoid bone and include multiple air cells. The frontal and sphenoid sinuses have more variable development and anatomy.
The document discusses the anatomy and variants of the paranasal sinuses relevant to functional endoscopic sinus surgery (FESS). It describes the four paired sinuses and their drainage pathways. Key anatomical structures for drainage include the osteomeatal complex and frontal recess. Common anatomic variants are described such as concha bullosa, Haller cells, and Onodi cells which can impact sinus drainage. Radiologists should evaluate pre-operative scans for variants that may obstruct drainage or pose surgical hazards. A systematic checklist is recommended to identify issues important for surgical planning.
ANATOMY OF MID EAR and related structures.pptxJitenLad2
The middle ear consists of the tympanic cavity, Eustachian tube, and mastoid air cell system. The tympanic cavity contains the ossicles and is bounded by walls that form compartments. It communicates with the nasopharynx via the Eustachian tube and with the mastoid antrum. The mastoid antrum leads to extensive air cells within the temporal bone. Structures like the facial nerve canal pass through the walls and roof of the middle ear.
This document provides an overview of the anatomy of the paranasal sinuses. There are four paired paranasal sinuses located in the skull bones surrounding the nasal cavity: the maxillary, frontal, ethmoid, and sphenoid sinuses. Each sinus has thin bony walls and is lined with mucous membrane continuous with the nasal cavity. The maxillary sinus is the largest sinus, located within the body of the maxilla bone. The ethmoid sinuses are numerous air cells located within the ethmoid bone between the orbit and nasal cavity. The frontal sinus is located within the frontal bone above the orbit, while the sphenoid sinus occupies the sphenoid bone behind the ethmoid labyrinth.
The document discusses the anatomy and imaging of the paranasal sinuses. It begins with the embryology of the sinuses, noting that the maxillary, ethmoid, and frontal sinuses develop from invaginations of the nasal cavity into bones. The anatomy sections describe each of the four major sinuses - maxillary, ethmoid, sphenoid, and frontal - as well as other structures like the osteomeatal complex and nasal passages. Variations in anatomy are also covered. Imaging modalities for evaluating the sinuses include conventional radiography, CT, and MRI, with CT considered the gold standard.
This document provides an overview of the paranasal sinuses. It discusses the development, anatomy, and functions of the frontal, ethmoidal, sphenoidal, and maxillary sinuses. It describes their development from diverticulae of the nasal cavity walls. The maxillary sinus is the largest sinus and develops earlier than the others. Clinical considerations include sinusitis, tumors, oroantral fistulas, and sinus lift procedures to augment bone for dental implants.
1. The nose is divided into an external pyramidal part made of bone and cartilage, and an internal nasal cavity divided by the nasal septum.
2. The external nose contains upper lateral, lower alar, and septal cartilages that provide structural support. The internal nasal cavity contains three turbinates that project from the walls.
3. The nasal cavity is divided into the anterior vestibule lined by skin and the mucosa-lined nasal cavity proper containing the olfactory region and respiratory region with pseudostratified epithelium. Various structures like the uncinate process and bulla ethmoidalis are related to sinus drainage and surgery.
The nose develops from the frontonasal process and surrounding structures in the embryo. It has bony and cartilaginous components that provide structure. The nasal cavities contain three turbinates and three meatuses for drainage. The paranasal sinuses develop later in life and include the maxillary, ethmoid, frontal, and sphenoid sinuses. The sinuses are lined with mucous membrane and have ostia that drain into the meatuses. The nose has important functions including warming, humidifying, and filtering air as well as roles in smell and voice resonance.
The document provides an overview of the nose, paranasal sinuses, and ear. It describes the external nose, nasal cavity, and paranasal sinuses which include the maxillary, frontal, sphenoid, and ethmoid sinuses. It then discusses the external, middle, and inner ear. The middle ear contains the auditory ossicles and tympanic membrane, while the inner ear houses the organs of hearing and balance within the bony labyrinth.
The summary of the document is:
1. The nose and paranasal sinuses develop between 4-8 weeks of fetal life from the frontonasal process and maxillary processes.
2. By 5-6 weeks, nasal placodes form and invaginate to form nasal pits which later fuse to form the primitive nasal cavity.
3. Between 7-10 weeks, the paranasal sinuses begin to form from outpocketings of the nasal mucosa. The maxillary sinus is the first to form around 3 months of gestation.
4. The external nose is made up of bones, cartilages and overlying skin and muscle. The internal nasal cavity has
The document summarizes key information about the maxillary sinus, including its development, anatomy, blood supply, drainage, and clinical importance. It begins with a brief overview of paranasal sinuses and then focuses on the maxillary sinus. The maxillary sinus develops from the maxillary process by 12 weeks gestation and increases in size throughout childhood and adulthood. It has multiple walls that form its boundaries and drains into the middle meatus through the maxillary ostium. Issues like sinusitis, dental infections, and trauma can involve the maxillary sinus.
The document discusses the embryology, growth, development, anatomy and surgical anatomy of the maxilla bone. It begins with the embryological development of the maxilla from the first pharyngeal arch. It then describes the growth of the maxilla through mechanisms such as displacement, growth at sutures and surface remodeling. The anatomy section outlines the structures of the maxilla including its processes, surfaces and features such as the maxillary sinus and alveolar process.
The paranasal sinuses drain into specific areas of the nasal cavity. The frontal sinuses drain into the frontoethmoidal recess. The anterior ethmoid air cells drain into the anterior aspects of the hiatus semilunaris. The middle ethmoid air cells drain through the ethmoid bulla into the superior meatus. The maxillary sinus drains via the infundibulum into the maxillary ostium. The sphenoid sinus drains into the sphenoethmoid recess posterior to the superior meatus. Coronal CT is the preferred imaging modality to evaluate the paranasal sinuses and displays important anatomical landmarks like the maxillary sinus, turbinates, nasal septum, and unc
SEMINAR 13 - OAC AND OAF - introduction , surgical anatomy of maxillary sinus...Alex343664
This document discusses oro-antral communication/fistula, including its etiology, clinical presentation, and diagnosis. It begins with an introduction and overview. It then covers anatomy of the maxillary sinus, its physiology, and common causes of oro-antral communication and fistula. These include anatomical variations, dental factors like long roots or periapical pathology, and surgical procedures. Clinical presentation and diagnosis are also briefly mentioned. The document provides detailed information on maxillary sinus anatomy and factors involved in oro-antral communication formation.
The document summarizes the anatomy of the nose and paranasal sinuses. It describes the external nose, nasal cavity, paranasal sinuses, blood supply, nerve supply, and functions of the nose. The external nose has a bony and cartilaginous framework that provides structure. Internally, the nasal cavity is divided by the nasal septum and contains the paranasal sinuses which include the maxillary, frontal, ethmoid, and sphenoid sinuses. The nose functions include filtration, warming and humidifying air, olfaction, and vocal resonance.
Cross Sectional Anatomy of Paranasal sinus Sarbesh Tiwari
The document summarizes the anatomy and variations of the paranasal sinuses. It describes the locations and openings of the different sinus groups. Key anatomical structures involved in sinus drainage like the osteomeatal complex are also explained. Common anatomic variations seen on imaging that can affect sinus drainage are discussed. These variations include concha bullosa, Haller cells, Onodi cells and pneumatization of surrounding bones.
Anatomy of middle ear ..................SruthiNaren
The middle ear cavity is an air-filled space located in the temporal bone between the external auditory meatus and inner ear. It is divided into the mesotympanum, epitympanum, and hypotympanum. The middle ear has four walls - medial, lateral, anterior, and posterior - with a roof and floor. The lateral wall contains the tympanic membrane and bony structures like the tympanic ring, scutum, and tympanic spines. The posterior wall houses the facial nerve and contains structures like the pyramidal eminence and aditus ad antrum. The floor is narrow and separates the middle ear from nearby blood vessels and jugular bulb.
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3. INTRODUCTION
• Paranasal sinuses are air-containing cavities in certain bones
of skull.
• They are four on each side. Clinically, paranasal sinuses have been
divided into two groups.
• The anterior and posterior groups.
4. CON’T
1. Anterior group,
• This includes maxillary, frontal and anterior ethmoidal.
• They all open in the middle meatus and their ostia lie anterior to
basal lamella of middle turbinate.
2. Posterior group.
This includes posterior ethmoidal sinuses which open in the superior
meatus and the sphenoid sinus which opens in sphenoethmoidal
recess.
5. MAXILLARY SINUS(ANTRUM OF HIGHMORE)
• It is the largest of paranasal sinuses and occupies the body of maxilla.
• It is pyramidal in shape with base towards lateral wall of nose and
apex directed laterally into the zygomatic process of maxilla and
sometimes in the zygomatic bone itself.
• On an average, maxillary sinus has a capacity of 15 mL in an adult. It is
33 mm high, 35 mm deep and 25 mm wide.
6. Coronal section showing relationship of maxillary
and ethmoidal sinuses to orbit and the nasal cavity
7. RELATIONS
• Anterior wall is formed by facial surface of maxilla and is related to
the soft tissues of cheek.
• Posterior wall is related to infratemporal and pterygopalatine fossae.
• Medial wall is related to the middle and inferior meatuses. At places,
this wall is thin and membranous. It is related to uncinate process,
anterior and posterior fontanelle, and inferior turbinate and meatus.
• Floor is formed by alveolar and palatine processes of the maxilla and
is situated about 1 cm below the level of floor of nose.
8. CON’T
• Usually it is related to the roots of second premolar and first molar
teeth.
• Depending on the age of the person and pneumatization of the sinus,
the roots of all the molars, sometimes the premolars and canine, are
in close relation to the floor of maxillary sinus separated from it by a
thin lamina of bone or even no bone at all.
• Oroantral fistulae can result from extraction of any of these teeth.
Dental infection is also an important cause of maxillary sinusitis.
• Ostium of the maxillary sinus is situated high up in medial wall and
opens in the posteroinferior part of ethmoidal infundibulum into the
middle meatus.
9. CON’T
• It is unfavourably situated for natural drainage. An accessory ostium
is also present behind the main ostium in 30% of cases.
• Roof of the maxillary sinus is formed by the floor of the orbit. It is
traversed by infraorbital nerve and vessels
10. FRONTAL SINUS
• Each frontal sinus is situated between the inner and outer tables of
frontal bone, above and deep to the supraorbital margin.
• It varies in shape and size and is often loculated by incomplete septa.
• The two frontal sinuses are often asymmetric and the intervening
bony septum is thin and often obliquely placed or may even be
deficient.
• . Frontal sinus may be absent on one or both sides or it may be very
large extending into orbital plate in the roof of the orbit.
• Its average dimensions are: height 32 mm, breadth 24 mm and depth
16 mm (remember code 8, i.e. 8 × 4, 8 × 3 and 8 × 2).
11. • Anterior wall of the sinus is related to the skin over the forehead.
• inferior wall, to the orbit and its contents;
• posterior wall to the meninges and frontal lobe of the brain.
12. CON’T
• Drainage of the frontal sinus is through its ostium into the frontal
recess.
• In fact frontal sinus, its ostium and the frontal recess form an hour
glass structure.
• Frontal recess is situated in the anterior part of middle meatus and is
bounded by the middle turbinate (medially), lamina papyracea
(laterally), agger nasi cells (anteriorly) and bulla ethmoidalis
(posteriorly).
• It may be encroached by several anterior ethmoidal cells, which may
obstruct its ventilation and drainage and lead to sinusitis
13. CON’T
• . Frontal recess drains into the infundibulum or medial to it,
depending on the superior attachment of the uncinate process.
• Due to encroachment of small air cells in the frontal recess, the
drainage pathway may be reduced to a straight or more often
tortuous pathway which was earlier called nasofrontal duct. It is an
erroneous term as no true duct exists.
14. ETHIMOIDAL SINUS(ETHIMOID HAIR CELLS)
• Ethmoidal sinuses are thin-walled air cavities in the lateral masses of
ethmoid bone.
• Their number varies from 3 to 18.
• They occupy the space between upper third of lateral nasal wall and
the medial wall of orbit.
• Clinically, ethmoidal cells are divided by the basal lamina into an
anterior ethmoid group which opens into the middle meatus and
posterior ethmoid group which opens into the superior meatus and
into supreme meatus, if that be present.
15. CON’T
• Roof of the ethmoid is formed by medial extension of the orbital plate
of the frontal bone, which shows depressions on its undersurface,
called fovea ethmoidalis.
• The lateral wall is formed by a thin plate of bone called lamina
papyracea
16. Anterior Group
Important ethmoid cells in the anterior group include:
1. Agger nasi cells – present in the Agger nasi ridge.
2. Ethmoid bulla – forms the posterior boundary of the hiatus
semilunaris.
3. Supraorbital cells.
4. Frontoethmoid cells – situated in the area of the frontal recess and
may encroach the frontal sinus.
5. Haller cells – situated in the floor of the orbit.
17. POSTERIOR GROUP
• The posterior group of ethmoid sinuses lies posterior to the basal
lamina of middle concha.
• They are 1–7 in number and open into superior meatus or in the
supreme meatus, when present.
• One important cell of this group is sphenoethmoid cell, also called the
Onodi cell. It is the most posterior cell of this group and extends along
the lamina papyracea, lateral or superior to the sphenoid and may
extend 1.5 cm behind the anterior face of sphenoid.
• Optic nerve and sometimes the carotid artery are related to it laterally
and are in danger during endoscopic surgery.
• At birth anterior ethmoids are 5 × 2 × 2 mm and posterior ethmoids are
5 × 4 × 2 mm. They attain their adult size by the 12th year.
18. SPHENOID SINUS
• It occupies the body of sphenoid. The two, right and left sinuses, are
rarely symmetrical and are separated by a thin bony septum which is
often obliquely placed and may even be deficient (compare frontal
sinus).
• Ostium of the sphenoid sinus is situated high up in the anterior wall
and opens into the sphenoethmoidal recess, medial to the superior or
supreme turbinate.
• It may be slit like, oval or round and can be seen endoscopically. In
adults, it is situated about 1.5 cm from the upper border of choana.
• The average distance from the anterior nasal spine to the ostium is
about 7 cm
19. CON’T
• An adult sphenoid sinus is about 2 cm high, 2 cm deep and 2 cm
wide, but its pneumatization varies.
• In some cases pneumatization may extend into greater or lesser wing
of sphenoid, pterygoid or clivus, i.e. basilar part of occipital bone.
20. Relations of the Sphenoid Sinus
• Lateral wall of the sphenoid is related to the optic nerve and
carotid artery. The opticocarotid recess can be seen in between the
two.
• It may extend laterally when the anterior clinoid processes are also
pneumatized. Maxillary nerve may be related to lower part of the
lateral wall of sphenoid. The optic nerve and internal carotid artery
are usually covered by a thin bone, but sometimes this bony covering
may be dehiscent, and then these structures lie exposed, covered
only by mucosa
21. CON’T
• Floor of the sinus is related to the Vidian nerve.
• Relation of the roof can be divided into two parts. Anterior part of
the roof is related to the olfactory tract, optic chiasma and frontal lobe,
while posterior part is related to the pituitary gland in the sella turcica
and laterally to the cavernous sinus.
• Posterior wall of the sphenoid forms the clivus.
• Relations of the sphenoid sinus are important in endoscopic skull
base surgery
24. MUCOUS MEMBRANE OF PARANASAL SINUSES
• Paranasal sinuses are lined by mucous membrane which is continuous
with that of the nasal cavity through the ostia of sinuses.
• It is thinner and less vascular compared to that of the nasal cavity.
Histologically, it is ciliated columnar epithelium with goblet cells
which secrete mucus.
• Cilia are more marked near the ostia of sinuses and help in drainage
of mucus into the nasal cavity.
25. DEVELOPMENT OF PARANASAL SINUSES
• Paranasal sinuses develop as outpouchings from the mucous
membrane of lateral wall of nose.
• At birth, only the maxillary and ethmoidal sinuses are present and
are large enough to be clinically significant.
• Growth of sinuses continues during childhood and early adult life.
• Radiologically, maxillary sinuses can be identified at 4–5 months,
ethmoids at 1 year, frontals at 6 years and sphenoids at 4 years
28. LYMPHATIC DRAINAGE
• The lymphatics of maxillary, ethmoid, frontal and sphenoid sinuses
form a capillary network in their lining mucosa and collect with
lymphatics of nasal cavity. Then they drain into lateral
retropharyngeal and/or jugulodigastric nodes.