The paranasal sinuses

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angelica candelaria
paranasal sinuses
• It is group of four paired air-
filled spaces that surround the
nasal cavity:
• The frontal sinuses are above
the eyes.
• the sphenoidal sinuses are
behind the eyes.
• The ethmoidal sinuses are
between the eyes .
• The maxillary sinuses are located
under the eyes.
A. FRONTAL SINUSES
• venous drainage
seen in frontal bone
1. small vein that unites the supraorbital
walls:
and superior opthalmic nerve
1. anterior and posterior table of the
frontal bone • nerve supply

2. intersinus septum 1. supraorbital nerve (ophthalmic nerve)

3. orbital roof, nasoethmoidal floor 2. supratrochlear nerve (ophthalmic
blood supply nerve)
1. supraorbital artery • lymphatic drainage
2. supratrochlear artery 1. submandibular nodes
 B. ethmoidal
• means sieve like
• Consist of 5 parts:
1. superior prominence (crista galli)
2. horizontal plate (cribriform plate)
3. horizontal part
4.-5. lateral part (Iateral lamella)
CRIBRIFORM PLATE
• separates the anterior cranial
cavity above from the nasal
cavity below.
• compose of 2 narrow plates on
either sides preforated by
olfactory nerve fibers process of
dura and ethmoid vessels and
nerves.
Blood supply
• Anterior ethmoid artery
(ophthalmic artery)
• Post. Ethmoidal artery
• Sphenoid artery (maxillary
artery)
-venous drainage
a. nasal veins
b. ant. ethmoid vein
c. post. ethmoid vein
continuation of 5 parts of
ethmoid
• 3. midline perpendicular plate
(perpendicular plate of ethmoid)
• 4.-5. two lateral masses or
labyrinths suspended from
horizontal arms in the shape of
the cross.
cont. of ethmoid
1. sup- pituary/optic chiasma
2. lat- ICA/optice nerve/cavernus
sinus
3. post- tuberculum sella
4. floor- vidian nerve
5. anterior- perpendicular plate of
ethmoid and vomer in the midline
and ethmoid bone in each side
• Ostium of the sphenoid sinus is
located in the sphenoethmoind
recess medial to the superior
supreme tubunates and close to
the nasal septum
few mm below the cribiform
plate- 1 cm above the choana
and the 5 mm later to nasal
septum
shape ostium varies widely with 2-
3 mm in diameter
continuation of ethmoid

• blood supply:
1. post. ethmoid artery( roof of
sinus)
2. Sphenoipalatine artery (roof of
sinus)
• Nerve
1. Trigeminal (1/11 div)
• Lymphatics
1. Retropharyngeal nodes
C. sphenoidal
• means wedge
• located inside the body of sphenoid
bone
• has 6 sides towards endocranial cavity
and 2 sides towards nasal cavity and
nasopharynx
• right and left are rarely symmetrical in
shape
• pneumatisation may extend into body
at sphenoid bone. pterygoid process,
basilar portion of occipital bone, nasal
septum/perpendicular plate of
ethmoid.
• boundaries
1. maxillary ostium:
- post part of the medial wall
- drains into mddle meatus through
ethmoidal infundibulum
2. accessory ostium:
- when present seen post. to natural
ostia
- almost always circular
- easily seen during endoscope
-myerson 1932-31 %
• Blood supply: • Nerve supply
- facial artery - greater palatine nerve
- infrorbital artery - post lateral nasal nerve
- greater palatine artery - superior alveolar ( infraorbital
- sphenopalatine artery nerve)
D. Maxillary sinus
-largest occupies entire body of
the maxilla
-roof = floor of the orbit
-nasal cavity is medial sinus
-roots of maxillary teeth in floor of
sinus( can damage by extraction)
-antrum of highmore
-largest pns/pyramidial cavity in
the maxillary bone
5 walls
• Ant: anterior surface of maxilla
• posteroilateral: zygomatic bone
and the greater wing of the
spenoidal bone.
• Med. lateral wall of the nasal
cavity at the level of the middle
and inferior meatus.
• sup. floor of orbital cavity
• inferior- alveolar and palatine
process of maxilla.
paranasal sinuses Nasal congestion:
histology Rhinosinusitis

• simliarly lined with ciliated • The paranasal sinuses communicate

epithelium with the nasal cavities through small
orifices called “ostia”. that is why an
• cilia beat mucous towards the
inflammation of the nose may spread
nasal cavity
to the sinuses, causing rhinosinusitis.
• thinner • inflammation leads to congestion of
• fewer and smaller glands the mucous membrane of the sinuses
• lamina propia is thin and blockage of the ostia. and
prevents the mucus from being
pushed toward the nose. “Stagnation”
can facilitate bacterial infections.
types of rhinosinusitis