Anatomy of the nose and paranasal sinuses

The nose is an organ in our body which plays an important role in our respiratory
tract system. The nose comprises the external nose and the nasal cavity. The nasal
septum divide the nasal cavity into right and left cavities. It has several functions
include olfaction (smelling), respiration (breathing), filtration of dust, humidification
of inhaled air, and reception and elimination of secretions from the paranasal
sinuses and nasolacrimal ducts. 1
I.1 External nose
The external nose is the visible part projecting from the face which has roughly
pyramidal shape. The skeleton of the external nose is formed of bone and hyaline
cartilage. The bony part of the nose includes the nasal bones, frontal processes of
the maxillae, the nasal part of the frontal bone, and its nasal spine, and the bony
parts of the nasal septum. There are five main cartilages that make the
cartilaginous part of the nose, which are two lateral cartilages, two alar cartilages,
and one septal cartilage.1
The parts of the external nose from the top to the bottom are root of the nose,
dorsum of the nose, apex (tip) of the nose, alae (wings) of the nose and the nares
(nostrils or anterior nasal apertures). The cartilaginous part of the nose has thicker
skin than the bony part and it has many sebaceous glands. This thicker skin extends
into the vestibule of the nose, where it has moisten stiff hairs that filter dust
particles from air entering the nasal cavity.
I.2 Nasal cavity
Nasal cavity is divided into two chambers by the nasal septum. The nasal septum is
made by a bony part (consists of perpendicular plate of the ethmoid bone, the
vomer, nasal crests of the maxillary and palatine bones) and a soft mobile
cartilaginous part. The nasal cavity is entered anteriorly through the nares and
opens posteriorly into the nasopharynx through the choanae.
The nasal mucosa is firmly attached to the periosteum and perichondrium of the
upporting bones and cartilages of the nose. The mucosa also lines the chambers
which communicate with the nasal cavity, such as the nasopharynx, the paranasal
sinuses, the lacrimal sac and conjunctiva. The superior one third of the nasal
mucosa is the olfactory area and the inferior two thirds is the respiratory area.
When the air passes over the respiratory area, it is warmed and moistened before it
passes through the rest of the upper respiratory tract to the lungs. The olfactory
area is composed of neuroepithelial cells which are specialized to serve a sensory
function for smelling.
On the nasal wall, there are prominent structures which are called nasal turbinates
(conchae). Below these turbinates, there are some meatus which provide drainage
for chambers and duct around the nasal cavity. The meatus inferior provides
drainage for the nasolacrimal duct, the middle meatus for frontal, anterior ethmoid,
and maxillary sinuses, while the superior meatus for posterior ethmoid and
sphenoid sinuses.

I.3 Paranasal sinuses

The paranasal sinuses are the chambers in cranial bones which filled with air that
come from the respiratory tract. These sinuses are named according to the bones in
which they are located, such as frontal sinuses, ethmoida cells, sphenoidal sinuses,
and maxillary sinuses.

1.3.1 Frontal sinuses

The right and left frontal sinuses are between the outer and the inner tables of the
frontal bone, posterior to the root of the nose. Each sinus drains through frontonasal
duct into the ethmoidal infundibulum, which opens into the semilunar hiatus of the
middle meatus.
1.3.2 Ethmoidal cells
The ethmoidal cells are small invaginations of the mucous membrane of the middle
and superior nasal meatus into the ethmoid bone. The anterior ethmoidal cells drain
directly or indirectly int the middle nasal meatus through the ethmoidal
infundibulum. The middle ethmoidal cells open directly into the middle meatus and
are sometimes called bullar cells. The posterior ethmoidal cells drain directly into
the superior meatus.
1.3.3 Sphenoidal sinuses
The sphenoidal sinuses are located in the body of sphenoid bone. The sphenoid
body is fragile, because of the extensive pneumatization (formation of air cells).
These sinuses drain into the superior nasal meatus.
1.3.4 Maxillary sinuses
The maxillary sinuses are the largest of the paranasal sinuses. Each sinus drains by
one or more openings (the maxillary ostium) into the middle nasal meatus.

1.4 Osteomeatal Complex

1.5 Vascularization and inervation of the nose and paranasal sinuses