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Anatomy of Nose & Paranasal Sinuses Supervisor: dr. Oscar Djauhari, Sp.THT-KL Presented by: Syaepul Firdaus (2011730107)
Anatomy of Nose & Paranasal Sinuses Supervisor: dr. Oscar Djauhari, Sp.THT-KL Presented by: Syaepul Firdaus (2011730107)

Anatomy of Nose & Paranasal Sinuses

Supervisor:

dr. Oscar Djauhari, Sp.THT-KL

Presented by:

Syaepul Firdaus (2011730107)

Clerkship of Ear Nose Throat – Head and Neck Department Regional Hospital R. Syamsudin SH Period 2015, 6th July – 15th August

External Nose  Pyramidal shape  Skeleton  partly bony and partly cartilaginous and membranous 
External Nose
 Pyramidal shape
 Skeleton  partly bony and partly cartilaginous and
membranous
 Nasal bones
 Narrow and thicker above
 Wider and thinner below
 Articulate firmly above with the nasal part of the frontal
bone with each other laterally with the nasal process of
the maxilla
External Nose (2)  Inferior: the upper lateral cartilages  continuous with the cartilaginous septum. 
External Nose (2)
 Inferior: the upper lateral cartilages  continuous with the
cartilaginous septum.
 The lobule of the nose is formed mostly by the lower
lateral cartilages, which consist of a medial and lateral
crus. There are several small cartilages within the nasal
ala.
 The chief arterial supply of the nose is from the facial
artery through the angular artery and superior labial
arteries. Venous drainage is similar, with a component
gaining access to the ophthalmic vein through draining
vessels from the trochlear and angular veins.
Nasal Cavity  = nasal fossae  Nasal septum  nasal septal cartilage, nasal crest of
Nasal Cavity
 = nasal fossae
 Nasal septum  nasal septal cartilage, nasal crest of
the maxilla, nasal crest of the palatine bone, the vomer,
and the perpendicular plate of the ethmoid bone.
 The lateral nasal wall  nasal turbinates
 The meatus are situated below the corresponding
turbinates
Lateral nasal wall. 1. frontal sinus; 2. middle nasal concha; 3. middle nasal meatus; 4. agger
Lateral nasal wall. 1. frontal sinus; 2. middle nasal concha; 3. middle nasal
meatus; 4. agger nasi; 5. atrium of middle nasal concha; 6. limen; 7. vestibule;
8. inferior nasal meatus; 9. incisive canal; 10. palatine process of maxilla; 11. s0ft
palate; 12. pharyngeal recess; 13. eustachian tube orifice; 14. torus tubarius; 15.
adenoid; 16. sphenoid sinus, 17. sphenoid sinus opening; 18. sphenoethmoidal
recess; 19. inferior nasal concha; 20. superior nasal meatus; 21. superior nasal
concha; 22. palatine bone.
Nasal septum. 1, Perpendicular plate; 2, cribriform plate; 3, crista galli; 4, frontal bone; 5, nasal
Nasal septum. 1, Perpendicular plate; 2, cribriform plate; 3, crista galli; 4,
frontal bone; 5, nasal bone; 6, septal cartilage; 7, medial crus; 8, anterior nasal
spine; 9, incisive canal; 10, palatine process; 11, perpendicular plate; 12,
postnasal spine; 13, horizontal plate; 14, lateral pterygoid plate; 15, medial
pterygoid plate; 16,sphenoid sinus; 17, crest; 18, body.
Blood Supply of Nasal Cavity  The arterial supply is from:  Internal carotid sources through
Blood Supply of Nasal Cavity
 The arterial supply is from:
 Internal carotid sources through the anterior and
posterior ethmoid arteries
 External carotid source through the sphenopalatine
artery.
 The greater palatine vessels
 The septal branch of the superior labial artery
 These form an important anastomotic network in the
anterior septum known as the Kiesselbach plexus,
which accounts for most nosebleeds.
Type of Paranasal Sinuses  Frontal sinus  Ethmoid sinus  Maxillary sinus  Sphenoid sinus
Type of Paranasal Sinuses
 Frontal sinus
 Ethmoid sinus
 Maxillary sinus
 Sphenoid sinus
Frontal Sinuses  Located in the frontal bone  It’s floor forming the medial portion of
Frontal Sinuses
 Located in the frontal bone
 It’s floor forming the medial portion of the orbital roof
 Bounded behind by the anterior cranial fossa
 Inflammations can give rise to serious complications because
of its close proximity to the orbit and cranial cavity
 Orbital cellulitis
 Epidural or subdural abscess
 Meningitis
 Two, three, or even more frontal sinuses on a side have been
reported, and some persons have no frontal sinus.
Ethmoid Sinuses  Pyramid-shaped and a labyrinthine system of small, pneumatized sinus cavities that are separated
Ethmoid Sinuses
 Pyramid-shaped and a labyrinthine system of small,
pneumatized sinus cavities that are separated from one another
by thin bony walls
 Superior and medial to the maxillary sinus are the ethmoid air
cells
 Anterior ethmoid cells – anterior and below: open into the
infundibulum of the middle meatus
 Posterior ethmoid cells – posterior and above: into the superior
meatus
 They lie on either side of the superior halves of the nasal cavities
and are separated from the orbits by the laminae papyraceae.
Sphenoid Sinuses  Located at the approximate center of the skull above the nasopharynx.  Borders:
Sphenoid Sinuses
 Located at the approximate center of the skull above the
nasopharynx.
 Borders:
 Its posterior wall is formed by the clivus.
 It relates laterally to the cavernous sinus, the internal carotid artery, and
cranial nerves II – VI, and it is very closely related to the optic canal.
 The optic nerve and the internal carotid artery may run directly beneath the
mucosa of the lateral wall of the sphenoid sinus
 Superiorly by the sella tursica and pituitary
 The anterior and middle is cranial fossae
 The degree of pneumatization of the sphenoid sinus varies  an
important factor in surgical approaches to the pituitary gland.
Maxillary Sinuses  The largest of the paranasal  Border: sinuses  The anterior wall forms
Maxillary Sinuses
 The largest of the paranasal
 Border:
sinuses
 The anterior wall forms the facial surface of the maxilla
 The
posterios wall borders the infratemporal fossa
 The medial wall constitutes the lateral wall of the nasal cavity
 The
 The
floor of the sinus is the alveolar process
superior wall serves as the orbital floor
 The infraorbital nerve crosses the orbital floor to exit the
anterior portion of the maxilla via the infraorbital foramen.
Drainage of Paranasal Sinuses  Meatus superior  Located below the superior turbinate and above the
Drainage of Paranasal Sinuses
 Meatus superior
 Located below the superior turbinate and above the medial
turbinate
 Drainage  the posterior ethmoid sinuses and sphenoid sinus
 Meatus media
 Located between the medial turbinate and inferior turbinate
 Drainage  the frontal sinus, maxillary sinus, and anterior
ethmoid sinus
 Meatus inferior
 Situated below the inferior turbinate
 The biggest meatus
 An orifice of the ipsilateral naso-lacrimal duct.
Paranasal sinuses. 1, Nasal septum; 2, frontal sinus; 3, nasal cavities; 4, ethmoidal cells; 5, middle
Paranasal sinuses. 1, Nasal septum; 2, frontal sinus; 3, nasal cavities;
4, ethmoidal cells; 5, middle nasal concha; 6, middle nasal meatus; 7,
maxillary sinus; 8, inferior nasal concha; 9, hard palate.
Osteomeatal Complex  A small constricted region which is prone to obstruction  Contained in the
Osteomeatal Complex
 A small constricted region which is prone to obstruction
 Contained in the middle third of lateral wall of the nose,
in the meatus medius, there orifice channel of maxillaryy
sinus, frontal sinus, anterior ethmoid sinuses.
 5 structures:
 Maxillary ostium
 Infundibulum
 Ethmoidal bullae
 Uncinate process
 Hiatus semilunaris
Physiology of Paranasal Sinuses  Acting as resonating chambers for the voice  Moisturize and humidify
Physiology of Paranasal Sinuses
 Acting as resonating chambers for the voice
 Moisturize and humidify ambient air
 Lightening the weight of the facial skeleton
Physiology of the Nose and Paranasal Sinuses  Respiratory function  air conditioning  Smelling 
Physiology of the Nose and Paranasal
Sinuses
 Respiratory function  air conditioning
 Smelling
 Fonetic function
 Static and mechanic function  lightening the weight
of facial skeleton, protection
 Nasal reflex
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