Beruflich Dokumente
Kultur Dokumente
By
Dr.K.PRASANNA
Radiology Resident
RMMCH
CONTENTS
NOSE AND NASAL FOSSA
PARA NASAL SINUSES
OSTEOMEATAL COMPLEX
ANATOMICAL VARIATIONS
IMAGING MODALITIES
CT PROCEDURE & SECTIONS
CONCLUSION
Nasal skin
Floor - Palatine
process of the maxilla
& Palatine bone
Medial wall
Lateral wall
Blood supply
Sphenopalatine artery
LATERAL WALL
Bony
Ethmoid infundibulum &
uncinate
Perpendicular plate of
palatine bone
Medial plate of pterygoid
Cartilage In
external nose, the
lateral wall of cavity
is supported by
cartilage (lateral
process of septal
cartilage & major,
minor alar cartilage)
LATERAL WALL
LATERAL WALL
Superior Meatus Limited only to posterior
Middle Meatus
Inferior Meatus Runs along the whole length
of lateral wall. Nasolacrimal duct opens in its
anterior part. Largest of all meatus
MIDDLE MEATUS
Bulla ethmoidalis Bulge
produced by the middle
ethmoidal cells
MIDDLE MEATUS
MIDDLE MEATUS
ETHMOID BONE
SINUSES
SINUSES
Sinuses
Sinuses
Clinically
- two
groups
Anterior
Frontal,
Maxillary,
Ant.Ethmoid
al
Posterior
Post
Ethmoidal,
Sphenoid
Middle
meatus
Sup. Meatus
&
sphenoethmo
idal recess
SINUSES
Significance
Lighten the skull & facial bones
Contributes to vocal resonance
Collapsible framework that helps the brain to protect
EPITHELIUM
Mucoperiosteum
Physiology
Approx 1.5 - 2
lit/day
Mucous produced
from the glands are
removed by two
mechanisms
Ciliary action
Slime trails
Sinuses Status at
First
Reache
Birth
Radiologi s Adult
cal
size by
evidence
Maxillary
sinus
Present at
birth
4-5 months
after birth
15 years
Ethmoid
sinus
Present at
birth
1 year
12 years
Sphenoid
sinus
Not Present
4 years
15 years
adult age
Frontal
Sinus
Not Present
6 years
Size
increases
until teens
Pyramidal in shape
On average,
it has capacity
of 14.75 ml (14-15)
DRAINAGE OSTIUM
FRONTAL SINUS
Funnel shaped
Asymmetrical
Frontal Sinus
Frontal Sinus
Boundaries
Frontal Sinus
FRONTAL RECESS
Frontal Sinus
Frontal Sinus
Sphenoid sinus
Sphenoid sinus
Sphenoid sinus
Relations
Anterior part
Roof olfactory tract, optic chiasma
Posterior part
Roof Pituitary gland in sella turcica
Lateral Cavernous sinus,ICA &
Sphenoid sinus
ETHMOID SINUS
Varies from 3 18
ETHMOID SINUS
ETHMOID SINUS
DRAINAGE:
Present at birth
ETHMOID SINUS
Relations
OSTEOMEATAL
COMPLEX
OSTEO MEATAL
COMPLEX
OSTEO MEATAL
COMPLEX
turbinate,
posteriorly and
papyracea.
Inferiorly and anteriorly
ethmoid bulla
frontal recess
uncinate process
infundibulum
hiatus semilunaris
middle meatus.
OSTEO MEATAL
COMPLEX
ANATOMICAL
VARIANTS
Variations of Middle
turbinate
Paradoxic
Curvature
Variations of Middle
turbinate
Concha Bullosa
It
middle turbinate.
Less
Variations of Middle
turbinate
Other Variations
Obstruction, secondary
inflammation, swollen
membranes, and
VARIATIONS OF UNCINATE
PROCESS
DEVIATION
Attachment
Pneumatization
Onodi Cells
Encountered rarely
Can lead to
distortion of optic
cannal configuration
Orbit at risk
IMAGING
MODALITIES
X RAY
CT
MRI
CT PROCEDURE &
SECTIONS
CT PROCEDURE &
SECTIONS
CT PROCEDURE &
SECTIONS
CT PROCEDURE &
SECTIONS
Section thickness-3mm
contigous
Kvp-125
Mas-80
SCAN LIMITS :
Axial image
CT axial section of
PNS - image
Axial image
IMAGING PLANE :
REIDSS LINE runs b/w infraorbital margin
(IOM line)
& EAM. (parallel - axial)
ALEXANDERS LINE perpendicular to reids
line. (perpendicular - coronal)
Contrast in CT PNS
CHECK LIST
AGE OF THE PATIENT
THANK YOU
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PRESENTATION