Beruflich Dokumente
Kultur Dokumente
Paranasal Sinuses
Dr. Vishal Sharma
Development of
nose
External Framework
External Framework
Nasal Bone
Frontal Process of Maxilla
Upper Lateral Nasal Cartilage
Lower Lateral Nasal (Alar) Cartilage
Septal Cartilage
Lesser Alar (Sesamoid) Cartilages
Internal Nose
Openings: Anterior nares & posterior
nares (Choanae).
Vestibule of nose: lined by skin
Nasal cavity proper:
Lateral Wall
Roof
Floor
Nasal Septum
Nasal Septum
Nasal Septum
1. Septal cartilage
2. Ethmoid plate
3. Vomer
4. Palatine crest
5. Maxillary crest
6. Vomeronasal
cartilage
Meatal Drainage
1. Inferior meatus: Nasolacrimal duct ( guarded at its end
by a mucosal valve called HASNERs valve )
2. Middle meatus:
a. Frontal
b. Anterior ethmoid
c. Maxillary (natural + accessory ostia)
3. Superior meatus: Posterior ethmoid
4. Spheno-ethmoidal recess: Sphenoid
Ostio-meatal Complex
Ostio-meatal Complex
Complex micro-architectural pathway in ethmoid
labyrinth that drains anterior group of paranasal
sinuses. Consists of: frontal recess + ethmoid
infundibulum + hiatus semilunaris + uncinate
process + bulla ethmoidalis + middle meatus.
Variants in O.M.C.
1. Concha bullosa (pneumatized M.T.)
2. Paradoxically curved middle turbinate
3. Medially turned uncinate process
4. Large bulla ethmoidalis
5. Hallers cell in orbital floor
6. Agger nasi cell anterior to M.T.
7. Onodi Cell with dehiscent Optic Nerve
8. Mucosal pathology
Concha bullosa
Concha bullosa
Haller cell
Mucosal disease
Blood Supply
1. Sphenopalatine artery (main artery)
2. Greater palatine artery
3. Superior labial artery
4. Anterior Ethmoidal artery
5. Posterior Ethmoidal artery
1, 2, 3 & 4 form Kiesselbachs plexus over
Littles area on anterior septum
Venous drainage
Ethmoidal veins: ophthalmic veins
cavernous sinus
Sphenopalatine vein: pterygoid plexus
maxillary vein
Woodruffs venous plexus: present on lateral wall
near posterior end of middle turbinate
Retro-columellar vein: behind columella
Lining Epithelium
Skin: over nasal vestibule
Olfactory epithelium: upper 1/3rd of nasal cavity
above superior turbinate
Respiratory epithelium (pseudo-stratified
ciliated columnar): rest of nasal cavity +
paranasal sinus
Lining Epithelium
Lymphatic Drainage
1. External nose & anterior nasal cavity
submandibular lymph nodes
2. Remaining nasal cavity
upper deep cervical lymph nodes
3. Nasal roof (dangerous area of nose)
subarachnoid space along olfactory nv
4. P.N.S. retropharyngeal & J.D. node
Paranasal Sinuses
Anterior group:
frontal
anterior ethmoidal
maxillary
Posterior group:
posterior ethmoidal
sphenoid
Development of P.N.S.
Appear
first
First X-ray
appearance
Reach adult
size by
Maxillary
At birth
4 mth
15 yr
Ethmoidal
At birth
1yr
12 yr
Sphenoid
2 yr
4 yr
18 yr
Frontal
4 yr
6 yr
15 yr
Muco-ciliary blanket
Goblet cells in nasal mucosa secrete a
mucous blanket; moved backwards like a
conveyer belt into nasopharynx.
Consists of:
Superficial mucous or gel layer
Deep serous or sol layer
Muco-ciliary blanket
Muco-ciliary blanket
Thank You