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    The Paranasal Sinuses

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    Simphiwe Cebisa
    The paranasal sinuses are air-filled cavities within the facial bones that are connected to the nasal cavity. There are four main paranasal sinuses: the frontal, ethmoidal, sphenoidal, and maxillary sinuses. The sinuses help humidify inhaled air and reduce skull weight. Infections of the sinuses, called sinusitis, are common and can spread from the nasal cavity. The maxillary sinus is the largest sinus and most commonly involved in sinusitis, especially in children.

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    The Paranasal Sinuses

    Uploaded by

    Simphiwe Cebisa
    13 views15 pages
    The paranasal sinuses are air-filled cavities within the facial bones that are connected to the nasal cavity. There are four main paranasal sinuses: the frontal, ethmoidal, sphenoidal, and maxillary sinuses. The sinuses help humidify inhaled air and reduce skull weight. Infections of the sinuses, called sinusitis, are common and can spread from the nasal cavity. The maxillary sinus is the largest sinus and most commonly involved in sinusitis, especially in children.

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    The paranasal sinuses

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    The paranasal sinuses are air-filled cavities within the facial bones that are connected to the nasal cavity. There are four main paranasal sinuses: the frontal, ethmoidal, sphenoidal, and maxillary sinuses. The sinuses help humidify inhaled air and reduce skull weight. Infections of the sinuses, called sinusitis, are common and can spread from the nasal cavity. The maxillary sinus is the largest sinus and most commonly involved in sinusitis, especially in children.

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    © All Rights Reserved
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    13 views15 pages

    The Paranasal Sinuses

    Uploaded by

    Simphiwe Cebisa
    The paranasal sinuses are air-filled cavities within the facial bones that are connected to the nasal cavity. There are four main paranasal sinuses: the frontal, ethmoidal, sphenoidal, and maxillary sinuses. The sinuses help humidify inhaled air and reduce skull weight. Infections of the sinuses, called sinusitis, are common and can spread from the nasal cavity. The maxillary sinus is the largest sinus and most commonly involved in sinusitis, especially in children.

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    At a glance
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    The nasal cavity has lateral walls with turbinates, a roof, floor and medial wall. The paranasal sinuses are air filled cavities within bones that drain into the nasal cavity and may help humidify air and reduce skull weight.

    The lateral wall contains 3 turbinates called conchae that direct airflow. The roof is formed by bones and the floor is the hard palate. The medial wall is the nasal septum.

    The paranasal sinuses are thought to humidify inspired air and reduce the weight of the skull. They are lined with mucosa and communicate with the nasal cavity via openings in the meatuses.

    The Paranasal Air Sinuses

    The nasal cavity.. Recap


    • Floor- roof of the mouth(hard palate)

    • Roof-bones in the anterior cranial fossa

    • Medial wall- nasal septum

    • Lateral wall- three shelf like projections


    called conchae/turbinates
    The lateral wall of the nose
    •The turbinates are responsible for forcing inhaled air to flow in a
    steady, regular pattern around the largest possible surface of cilia and
    climate controlling tissue.

    •Superior concha- overlies the superior meatus.

    •Middle concha- overlies the middle meatus- projection called


    ethmoidal bulla beneath the bulla is the hiatus semilunaris.

    •Inferior concha-overlies the inferior meatus, which receives the


    nasolacrimal duct draining tears from the eyes

    •Spheno-ethmoidal recess receives the opening of the sphenoidal air


    sinus
    • The nasolacrimal duct
    Functions of the paranasal sinuses
    • Certain bones form boundaries of the nasal
    cavity and they are hollowed out and are lined
    with respiratory mucus and communicate with
    the nasal cavity via the meatuses -paranasal air
    sinuses- frontal, sphenoid, maxillary, ethmoid

    • The function of the sinuses is not clear. It is


    thought that they may contribute to
    the humidifying of the inspired air. They also
    reduce the weight of the skull.
    Maxillary air sinus
    • The largest of the sinuses.
    • It is located laterally and slightly inferiorly to the nasal cavities.
    • It drains into the nasal cavity at the hiatus semilunaris, underneath the frontal sinus opening. This is a potential pathway
    for spread of infection – fluid draining from the frontal sinus can enter the maxillary sinus.
    • Most common sinus involved in sinusitis especially in children, because it is the first to develop.

    • Nathaniel Highmore (1651) observed the


    clinical significance of the maxillary sinus
    and this brought about public
    consciousness of the sinuses (Laitman,
    2008). The maxillary sinus is also known
    as the Antrum of Highmore and is a
    recognised landmark in head and neck
    surgery.
    Maxillary air sinus
    • The space is enclosed within the body of the maxilla

    • Pyramidal in shape

    • Base-lateral wall of the nose

    • Apex-zygomatic process

    • Roof-floor of the orbit(infraorbital nerve)

    • Floor-alveolar part(teeth bearing) of the maxilla

    • The ostium is high up and is 3-4 mm opens in the middle


    meatus

    • Nerve supply- branches of the maxillary nerve-superior


    alveolar, anterior palatine and infraorbital nerve
    Sphenoidal air sinus
    • Formed within the body of the sphenoid
    bone

    • Lies beneath the pituitary fossa

    • They are found more posteriorly, and are


    related superiorly and laterally to
    the cranial cavity. The sphenoid sinuses
    drain out onto the roof of the nasal cavity.

    • The sinus opens into the spheno-ethmoidal


    recess
    • Nerve supply-posterior ethmoidal nerve
    • The relationships of this sinus are of clinical importance – the pituitary gland can be surgically
    accessed via passing through the nasal roof, into the sphenoid sinus and through the sphenoid
    bone.
    Frontal air sinus
    • Lies within the diploe of the frontal bone

    • It extends upweards above the medial end of the

    eyebrow and backwards into the medial part of the roof

    of the orbit

    • The frontal bone articulates with the ethmoidal labyrinth

    • Frontal sinus opens into the hiatus semilunaris of the

    middle meatus through the infundibulum

    • Nerve supply-supraorbital nerve


    Frontal air sinus
    Frontal air sinus

    • Did you know…….

    that the frontal sinus is


    different and unique in
    every single person and
    can be used to identify
    an individual same like
    your fingerprint -frontal
    sinus print
    Ethmoidal air sinus
    •Lie between the orbit and nose
    •In the lateral mass(labyrinth) of the ethmoid bone
    •The ethmoid bone consist of two lateral masses connected to the
    cribriform plate
    •Lateral mass is walled in thin bone
    •The superior and middle concha project from the lateral mass.
    •The lateral mass is divided into anterior, posterior and middle
    ethmoidal air cells
    •There are three ethmoidal sinuses; anterior, middle and posterior.
    They empty into the nasal cavity at different places:
    •Anterior – Hiatus semilunaris
    •Middle – Ethmoid bulla
    •Posterior – Superior meatus
    Ethmoidal air sinus
    • Posterior ethmoidal air sinus-
    opens into the superior meatus.
    Nerve supply-posterior
    ethmoidal nerve
    • Middle ethmoidal sinus-Projects
    into the lateral wall undercover
    the middle concha forming the
    ethmoidal bulla. Nerve supply-
    anterior ethmoidal nerve
    • Anterior ethmoidal air sinus-
    Opens into the anterior part of
    the hiatus semilunaris- nerve
    supply-ant ethmoidal nerve
    Drainage of the sinuses
    Parasympathetic Innervation
    • Please note this is via the pterygopalatine ganglion. Please know pathway
    from facial nerve to ganglion.

    • This ganglion serves a relay station for secretomotor fibres to the lacrimal
    gland, mucous glands , the paranasal sinus, the palate and pharynx. It is
    related to maxillary nerve topographically but functionally to the facial
    nerve. Hence postganglionic fibres will pass from ganglion to the branches
    of the maxillary nerve to the sinuses
    Clinical relevance
    • Endoscopic surgery (As seen on the left)

    • As the paranasal sinuses are continuous with


    the nasal cavity, an upper respiratory tract
    infection can spread to the sinuses. Infection of
    the sinuses causes inflammation (particularly
    pain and swelling) of the mucosa, and is known
    as sinusitis. If more than one sinus is affected, it
    is called pansinusitis.

    • The maxillary nerve supplies both the maxillary


    sinus and maxillary teeth, and so inflammation
    of that sinus can present with toothache.

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