Paranasal sinuses

1. Paranasal sinuses

2. Introduction
• Pneumatic bones
• Location
• Relation to nasal cavity
• Mucosa of sinuses

4. 4
Function of Paranasal Sinuses
• Humidifying and warming inspired air
• Regulation of intranasal pressure
• Increasing surface area for olfaction
• Lightening the skull
• Resonance
• Absorbing shock
• Contribute to facial growth

5. Paranasal sinuses
• 4 in no.
• Divisions – anterior & posterior
• Anterior- maxillary, frontal & anterior
ethmoidal sinuses
• Posterior – middle, posterior ethmoidal &
sphenoidal sinuses

7. Frontal sinus
• Shape
• Location
• Size & no

8. • Relations – anterior , floor , posterior
• Communications – to middle meatus directly
or frontonasal duct

10. • Blood supply
• Nerve supply
• Lymphatic drainage

11. Ethmoidal sinus
• Location
• Groups & no.
• Relations – roof , lateral wall
• Communications

12. • Blood supply
• Lymphatic drainage

13. Maxillary sinus
• Shape
• Location
• Size & no.
• Relations
• Communications

15. 15
Osteomeatal Complex
Middle meatus
Maxillary Sinus Ostium
Anterior Ethmoid
Drainage

16. • Blood supply
• Nerve supply
• Lymphatic drainage

17. Sphenoidal sinus
• Location
• Size & no.
• Relations
• Communications

19. • Blood supply
• Nerve supply
• Lymphatic drainage

21. Applied anatomy
• Sinusitis – acute & chronic
• Neoplasms

22. Sinusitis
• Causes
• Clinical features
• Diagnosis
• Treatment – medical & surgical
• Complications

23. causes
• Obstruction to sinus ventilation & drainage
• Nasal infection
• Swimming & diving
• Trauma
• Dental infection

24. Maxillary sinusitis- Water’s ie

25. Clinical features
• Constitutional symptoms
• Headache
• Tenderness
• Oedema of eyelid
• Nasal discharge
• Postnasal discharge

26. Investigations
• X-ray – lateral & ater’s ie
• CT scan
• MRI

27. Water’s ie

28. Caldwell view

29. Lateral view

30. CT picture of sphenoidal sinus

31. Surgical Treatment
• Frontal sinusitis – Trephination of frontal sinus
- intranasal drainage operations
- external frontoethmoidectomy
( Ho arth’s or Lynch operation)
- osteoplastic flap operation

33. • Maxillary sinusitis – antral puncture &
irrigation
- intranasal antrostomy
- caldwell- luc operation

36. • Ethmoid sinusitis – external ethmoidectomy
- intranasal ethmoidectomy
• Sphenoidal sinusitis – sphenoidotomy

37. Sphenoidotomy Intranasal ethmoidectomy

38. Complications
1. Orbital complications
2. Osteomyelitis
3. Intracranial
4. Descending infections
5. Focal infections

41. THANK YOU…