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Joan S.JJ Santos


Dr. Katrina G. Roslin



Paranasal air sinuses are air filled spaces within the bones around the ETHMOIDAL
nasal cavity. They communicate with the nasal cavity through various SINUS

narrow channels. They are lined by mucous membrane consisting of

pseudostratified ciliated columnar epithelium which is continuous with the
mucous membrane of nasal cavity SPHENOIDAL
The maxillary sinus or also known as Antrum of Highmore is the largest
air sinus. It is present in the body of maxilla, one on either side of the nasal
cavity. It drains into the hiatus semilunaris of the middle meatus in the MAXILLARY SINUS
posterior part.
There are four paranasal sinuses and these are: Frontal, ethmoidal,
sphenoid, and maxillary sinuses


➢ Imparts resonance to the voice

➢ Increases the surface area and lighters the skull
➢ Moistens and warms inspired air
➢ Filters the debris from the inspired air
➢ Mucus production and storage
➢ Limit extent of facial injury from trauma
➢ Provides thermal insulation to important tissues
➢ Serves as accessory olfactory organs

Maxillary sinus is the first of the PNS to develop.

It start as a shallow groove on the medial surface of maxilla during the 4th month of intrauterine
Expansion occurs more rapidly until all the permanent teeth have erupted.
It reaches to maximum size around 18 years of age.
In the 4th week I.U.L. – dorsal portion of 1st Pharyngeal arch forms the maxillary process, which
extends forward and beneath the developing eye to give rise to the maxilla.
DEVELOPMENT Horizontal shift of the Palatal Shelves and subsequent
fusion with one another

Nasal septum separates the 2nd oral cavity from the two
nasal chambers

Influences further expansion of the lateral nasal wall

and 3 wall begin to fold

3 conchae and meatuses arise

• Superior and Inferior meatuses remains as shallow and
depressions along the lateral nasal wall for the first half
of IUL.
• Middle meatus expands immediately into lateral nasal
wall and expands in an inferior direction occupying more
of the future maxillary body.
Blood supply innervation

Arterial Supply: Nerve Supply:

• Facial Artery • Anterior superior alveolar nerve
• Maxillary Artery • Middle superior alveolar nerve
• Infraorbital Artery • Posterior superior alveolar nerve
• Greater Palatine artery • Infraorbital nerve
Venous Drainage: • Greater palatine nerve

• Anteriorly: Sphenopalatine vein Lymphatic Drainage:

• Posteriorly: Pterygoid venous plexus drain into • Submandibular lymph node
facial vein • Deep cervical lymph node
• Pterygoid plexus communicates with cavernous • Retropharyngeal lymph node
sinus by emissary vein.

Shape: Pyramidal
Size: Variable
• APEX: Zygomatic process of maxilla
• BASE: Nasal surface of maxilla (formed by lateral wall of nose)
• ROOF: Orbital surface of maxilla (formed by thin orbital part)
• FLOOR: Lateral hard palate, Alveolar process of maxilla
• ANTERIOR WALL: wall is related to infra-orbital plexus of nerves and vessels and origin of muscles of upper
• POSTERIOR WALL: pierced by posterior superior alveolar nerve and vessels which travel to molar teeth.
Microscopic features

The maxillary sinus is lined with a mucous membrane of the respiratory type.
The antral mucous membrane is formed of:

An epithelial resting on a basement membrane.

- the epithelial layer of maxillary sinus lining is thinner than nasal
cavity. It is lined by Ciliated Pseudostratified Columnar Epithelium
derived from olfactory epithelium of middle nasal meatus.
-Most numerous cells- Columnar ciliated cells
-Additional cells- Basal cells, Columnar non ciliated cells, Goblet

An epithelial resting on a basement membrane.

Ciliated cells
–The cilia is composed of typical 9+1 pairs of microtubules and provide
mobile apparatus to the sinus epithelium which moves the debris,
microorganisms, and the mucous film lining the epithelial surface of
the sinus into the nasal cavity through ostium.
An epithelial resting on a basement membrane.
Goblet cells
–It is a mucous synthesizing and secreting cells
-it resembles an inverted wine glass with a short stack like basal end
containing mucin.

Subepithelial connective tissue layer

- It is formed of connective tissue cells, and intracellular
substance of collagen bundles and few elastic fibers and it is
moderately vascular.
- The lamina propria contains subepithelial antral glands
composed of mixed glands formed of serous and mucous acini
or mixed acini as well as myoepithelial cells.