Scribd Logo
Upload

Welcome to Scribd!

  • 67 views

    Paranasal Sinus 2002 01 Slides

    Uploaded by

    Sherhaniz Melissa Abidin
    The paranasal sinuses are air-filled cavities within the facial bones that are connected to the nasal cavity. There are four paired sinuses - the maxillary, frontal, ethmoid, and sphenoid sinuses. The sinuses develop from embryonic pouches and grow in a biphasic pattern throughout childhood. Mucociliary clearance helps humidify and warm inhaled air and traps particles to aid the immune response. The complex anatomy of the sinuses includes thin bony walls, drainage pathways, arteries, nerves and related structures like the osteomeatal complex.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Paranasal Sinus 2002 01 Slides

    Uploaded by

    Sherhaniz Melissa Abidin
    67 views49 pages
    The paranasal sinuses are air-filled cavities within the facial bones that are connected to the nasal cavity. There are four paired sinuses - the maxillary, frontal, ethmoid, and sphenoid sinuses. The sinuses develop from embryonic pouches and grow in a biphasic pattern throughout childhood. Mucociliary clearance helps humidify and warm inhaled air and traps particles to aid the immune response. The complex anatomy of the sinuses includes thin bony walls, drainage pathways, arteries, nerves and related structures like the osteomeatal complex.

    Original Description:

    paranasal

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    The paranasal sinuses are air-filled cavities within the facial bones that are connected to the nasal cavity. There are four paired sinuses - the maxillary, frontal, ethmoid, and sphenoid sinuses. The sinuses develop from embryonic pouches and grow in a biphasic pattern throughout childhood. Mucociliary clearance helps humidify and warm inhaled air and traps particles to aid the immune response. The complex anatomy of the sinuses includes thin bony walls, drainage pathways, arteries, nerves and related structures like the osteomeatal complex.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    67 views49 pages

    Paranasal Sinus 2002 01 Slides

    Uploaded by

    Sherhaniz Melissa Abidin
    The paranasal sinuses are air-filled cavities within the facial bones that are connected to the nasal cavity. There are four paired sinuses - the maxillary, frontal, ethmoid, and sphenoid sinuses. The sinuses develop from embryonic pouches and grow in a biphasic pattern throughout childhood. Mucociliary clearance helps humidify and warm inhaled air and traps particles to aid the immune response. The complex anatomy of the sinuses includes thin bony walls, drainage pathways, arteries, nerves and related structures like the osteomeatal complex.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 49

    Paranasal Sinuses:

    Anatomy and Function


    Glen T. Porter, MD
    Francis B. Quinn, MD, FACS
    The University of Texas Medical Branch
    Department of Otolaryngology
    Galveston, Texas
    Grand Rounds Presentation
    January 2002
    1

    Case Report1000B.C.
    2

    Sinus Anatomy Overview


    7 bones
    4 paired sinuses
    4 turbinates
    3 meati
    Drainage system
    Nervous supply
    Vascular supply
    Related structures

    Embryology
    Maxilloturbinal
    Ethmoturbinal
    Middle turbinate
    Superior turbinate
    Supreme turbinate

    Agger nasi
    Uncinate process
    Ethmoid infundibulum
    Sinuses

    Maxillary
    Ethmoid

    Sinus
    Development

    Pediatric Sinuses

    Bony Structure
    Ethmoid
    Maxilla
    Palatine
    Lacrimal
    Pterygoid plate of
    Sphenoid
    Nasal
    Inferior Turbinate
    7

    Arterial Supply

    External Carotid
    Maxillary A.
    Sphenopalatine
    Internal Carotid
    Ophthalmic A.
    Ant. Ethmoid
    Post. Ethmoid
    Supraorbital
    Supratrochlear

    Innervation

    Neurovascular Supply
    10

    Sinus Drainage Schema

    11

    Ethmoid Sinus
    Development
    Present at birth
    Anterior/Posterior
    Variability

    Structure
    Volume/shape
    Roof
    Lateral wall

    12

    Ethmoid Roof

    Anterior 2/3
    Posterior 1/3
    Keros I
    Keros II
    Keros III

    13

    Ethmoid
    Cells

    14Supraorbital, Frontal Bulla, Concha Bullosa, Hallers, Onodi Cells

    Ethmoid SinusRelated
    Structures
    Basal Lamella of the Middle Turbinate

    Three planes

    Agger nasi cell

    Childhood sinus

    Ethmoid Bulla

    Hiatus Semiluninaris/Superior Hiatus Semilunaris


    Suprabullar/retrobullar recesses (Sinus Lateralis)

    Ethmoid Infundibulum/Uncinate Process


    Anterior/Posterior Ethmoid Arteries
    Osteomeatal complex

    15

    Basal/Ground
    Lamella
    16

    Basal/Ground Lamella
    Of the Middle Turbinate

    The Agger Nasi Cell

    17

    Ethmoid Bulla
    Uncinate Process
    Hiatus Semilunaris

    18

    Ethmoid Infundibulum

    19

    Suprabullar/Retrobullar Recess

    20

    Ethmoid Arteries

    21

    Osteomeatal Complex

    22

    Middle meatus
    Maxillary Sinus Ostium
    Anterior Ethmoid
    Drainage

    Maxillary Sinus
    Development
    Present at birth
    Biphasic growth
    Level of the floor

    Structure
    Volume & shape
    Walls, floor, roof

    23

    Maxillary Sinus

    24

    Maxillary
    Sinus

    25

    Maxillary Sinus
    Related Structures
    Fontanelles
    Natural ostium

    Hallers Cells &Sinusitis


    Osteomeatal complex

    Accessory Ostium
    Nasolacrimal duct

    26

    Fontanelles

    27

    Natural Ostium
    -Hallers cells
    Accessory Ostium

    28

    Nasolacrimal Duct

    29

    Frontal Sinus
    Development

    Frontal bone at birth


    Age 5

    Structure

    Volume and shape


    Ostium
    Walls

    Anterior vs. posterior

    Related Structures

    30

    Frontal recess

    Frontal Sinus
    Ostium
    Frontal recess
    Boundaries
    Dumbbell shape

    Sinus Lateralis
    Frontal Bulla

    31

    Sphenoidal Sinus
    Development
    Arise within the nasal capsule (no pouch)
    Age 3 begins to pneumatize

    Structure

    Volume/variable pneumatization
    Wall thickness
    Position within the sphenoid

    32

    Relation to sella turcica


    Sellar and postsellar relationships

    Sphenoid Sinus Pneumatization

    33

    Sphenoid Sinus

    Sphenoid Sinus

    34

    Sphenoid Sinus

    35

    Sphenoid Sinus
    Ostium

    Size (.5-4mm)
    Location (sinus floor, anterior nasal floor, anterior
    sinus wall, superior turbinate, cribiform plate)
    Bony dehiscence

    Related Structures

    36

    Sphenoethmoidal recess
    Sphenoid rostrum
    Onodi cell

    Sphenoid Ostium
    Sphenoethmoid Recess
    Sphenoid Rostrum

    37

    The Onodi Cell

    38

    Microscopic Anatomy
    Mucosa

    Cilliated columnar epithelial cells


    Anatomy
    Beat frequency
    Inhibitory effects of contact

    Noncilliated columnar cells


    Distribution
    Function

    39

    Basal cells

    Microscopic AnatomyContd
    Goblet Cells
    Glycoproteinsviscosity and elasticity
    Innervation (para=thick, symp=thin)

    Basement membrane

    Submucosal glands

    40

    Distribution

    Microscopic Anatomy

    41

    Mucous Blanket
    Two layers
    Superficial layer
    Sol layer

    Function
    Superficial layer traps bacteria and
    particulate matter.
    Enzymes, antibodies, immune cells

    42

    Mucociliary Transport
    Directional Flow of Mucous

    Toward the choanae

    Ostium drainagea stubborn beast

    Hilding, MD

    Contact inhibition
    Hallers cells
    Surgery

    43

    Mucociliary Transport

    44

    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
    45

    New Frontiers
    Sleep apnea and the sinuses

    Humidification contributes up to 6.9mm Hg serum


    pO2
    Mouth breathers noted to have decreased end-tital
    CO2increased serum CO2apneas (high
    baseline)

    Nitric Oxide (NO)

    46

    NO produced primarily in sinuses


    Toxic to bacteria, fungi, viruses
    Increases cilliary motility

    Case Report
    39 yom with h/o sinus disease c/o
    headache, rhinorrhea.
    PMHx of sinus surgery years ago
    ROS reveals h/o two episodes of
    meningitis in past few years
    PE: right superior nasal mass. S/p
    FESS. Clear rhinorrhea.
    47

    48

    References
    Anon, Jack B., et al, Anatomy of the Paranasal Sinuses, Theime, New York,
    c1996.
    Bhatt, Nikhil J., Endoscopic Sinus Surgery: New Horizons, Singular
    Publishing Group, Inc., San Diego, c1997.
    Bailey, Byron J., et al, Head & Neck Surgery -- Otolaryngology, Lippincott
    Williams & Wilkins, Philadelphia, c2001.
    Lundberg, J., Weitzberg, E. Nasal Nitric Oxide in Man. Thorax 1999;
    54(10):947-952.
    McCaffrey, Thomas V., Rhinologic Diagnosis and Treatment, Thieme, New
    York, c1997.
    Marks, Steven C. Nasal and Sinus Surgery, W.B. Saunders Co., Philadelphia,
    c2000.
    Navarro, Joao A.C., The Nasal Cavity and Paranasal Sinuses, Springer,
    Berlin, c2001.
    Watelet, J.B., Cauwenberge P. Van, Applied Anatomy and Physiology of the
    Nose and Paranasal Sinuses. Allergy 1999; 54, Supp 57:14-25.

    49

    You might also like