[UNIT 6]: M.

01 ANATOMY OF THE NOSE AND PARANASAL SINUSES OTORHINOLARYNGOLOGY

Saint Louis University
Dr. Adaci
School of Medicine
02.28-03.05.2022

OUTLINE Ø Skin
I. THE NOSE • Thin over the upper part of the nose and thicker over the
II. EXTERNAL NOSE lower part where it contains sebaceous glands.
III. NASAL CAVITY Ø These are the landmarks to be noted:
IV. PARANASAL SINUSES • Glabella: the midpoint between the two eyebrows
V. OSTEOMEATAL COMPLEX • Nasion
• Rhinion
I. THE NOSE • Columella
• Philtrum

Figure 4. External Nose

Ø The external nose is divided into upper bony or osseous portion

Figure 1. Anatomy of the nose made up of the nasal bones, and a lower cartilaginous area.
Ø Landmarks that should be noted:
Ø Nasion:
Ø Consists of the external nose and the nasal cavity • The midpoint or the most anterior portion of the
Ø External nose has two elliptical orifices called the naris/nares frontonasal junction.
(nostrils), which are separated from each other by the columella
• Frontonasal junction:
օ Where the upper border of the nasal bones attaches
with the inferior border of the frontal bone
Ø Rhinion
• The midpoint of the osseocartilaginous junction
• Where the upper border of the upper lateral cartilage
attaches with the inferior border of the nasal bone.
Ø Sellion/radix
• The deepest portion at the root of the nose which usually
corresponds to the nasofrontal suture line.
Figure 2. Columella (red line)

Ø Columella
• Composed of a strip of skin, connective tissue and medial
crura of the lower lateral cartilage.
Ø Ala nasi
• Lateral border rounded and mobile.

II. EXTERNAL NOSE

Figure 5. Anterolateral View of the External Nose

Figure 3. External Nose

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 [UNIT 6]: M.01 ANATOMY OF THE NOSE AND PARANASAL SINUSES OTORHINOLARYNGOLOGY
Saint Louis University
Dr. Adaci
School of Medicine
02.28-03.05.2022

Ø The framework of the upper part of the external nose is made

up by the paired nasal bones, frontal processes of the maxillae,
and the nasal part of the frontal bone.
Ø The framework of the lower portion of the external nose is
formed by plates of hyaline cartilages: lateral cartilages (upper
lateral cartilage), greater alar cartilages (lower lateral cartilage),
lesser alar cartilages, septal cartilage (unpaired)

Figure 8. Anatomy of the Piriform Aperture

B. BLOOD SUPPLY OF THE EXTERNAL NOSE

Ø Skin of the external nose is supplied by branches of the
ophthalmic, which comes from the internal carotid artery, and
the maxillary arteries, which comes from the external carotid
Figure 6. Image showing the upper and lower portion of the external artery.
nose Ø Skin of the ala and the lower part of the septum are supplied by
branches from the facial artery, which is also a branch of the
external carotid artery.
A. NASAL MUSCULATURE
C. NERVE SUPPLY OF THE EXTERNAL NOSE
Ø Infratrochlear and external nasal branches of the ophthalmic
nerve (CN V)
Ø Infraorbital branch of the maxillary nerve (CN V).

III. NASAL CAVITY

Ø Divided into right and left nasal cavities by nasal septum.
Ø The most inferior margin of the nasal septum is the columella.
Ø The nasal cavity communicates anteriorly through the naris or
nostril to nasopharynx and posterior nasal aperture or choana
Ø The nasal cavity has:
• A floor, a roof, a lateral wall
• A medial or septal wall.
Ø Two portions:
• Skin lined portion – vestibule
• Mucosa lined portion – nasal cavity proper.

Figure 7. Nasal Musculature

Ø Elevator muscle group: Procerus, Levator Labii Superioris

Alaeque Nasi
Ø Depressor Muscle Group: Alar Nasalis, Depressor Septi Nasi
Ø Compressor Muscle Group: Transverse Nasalis
Ø Dilator Muscle Group: Dilator Naris Anterior and Posterior.
• Useful during nasal flaring in respiratory distress to aid in
respiration
Ø Piriform Aperture (Anterior Nasal Aperture)
• It is heart shaped opening in the skull.
• Opening to the bony area of the nose.
• This is what you’ll see if you remove the soft tissues and
muscles of the nose

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 [UNIT 6]: M.01 ANATOMY OF THE NOSE AND PARANASAL SINUSES OTORHINOLARYNGOLOGY
Saint Louis University
Dr. Adaci
School of Medicine
02.28-03.05.2022

B. ROOF OF THE NASAL CAVITY

Ø Narrow
Ø It is formed:
• Anteriorly beneath the bridge of the nose by the nasal and
frontal bones
• In the middle by the cribriform plate of the ethmoid
• Located beneath the cranial fossa
• Posteriorly by the downward sloping body of the sphenoid

Figure 9. Nasal Cavity

Ø Vestibule
• Located just after the opening of the nose
• A slight dilatation inside the aperture of the nostril lined by
skin containing hairs (vibrissae), sebaceous glands, and
extends as a small recess toward the apex of the nose.

Ø Limen nasi
• Upper limit of the vestibule on the lateral wall.
• Corresponds to the lower border of the upper lateral
cartilage.

Ø Nasal Valve
• Located in the junction between the vestibule and the
mucosal portion of the nasal cavity.
• Narrowest part of the nasal airway bounded laterally by
lower border of upper lateral cartilage and fibrofatty tissue
and anterior end of inferior turbinate, medially by
cartilaginous nasal septum and caudally by floor of
pyriform aperture.
• Area with highest nasal airway resistance.
• Limit’s airflow.
Figure 12. Roof of the nasal cavity
C. MEDIAL WALL OF THE NASAL CAVITY
Ø Nasal septum
Ø It has osseus and cartilaginous parts
Ø Consists of the perpendicular plate of the ethmoid bone
(superior portion of the nasal septum), the vomer
(posterior/inferior) and septal/quadrangular cartilage (anterior)

Figure 10. Nasal Valve

A. FLOOR OF THE NASAL CAVITY

Ø Composed of:
• Palatine process maxilla – located anteriorly
• Horizontal plate palatine bone – located posteriorly
Figure 13. Medial wall of the nasal cavity

BLOOD SUPPLY OF THE NASAL SEPTUM

Ø Kiesselbach’s plexus/Little’s area – confluence of vessels
along the anterior nasal septum where the septal branch of the
sphenopalatine artery, anterior ethmoidal artery branches,
greater palatine artery and septal branches of the superior labial
artery anastomose.
Ø This plexus is the most common cause of anterior epistaxis.
Ø Blood supply comes from the posterior and anterior ethmoidal
arteries from the sphenopalatine artery, greater palatine artery,
and the superior labial artery.

Figure 11. Floor of the Nasal Cavity

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 [UNIT 6]: M.01 ANATOMY OF THE NOSE AND PARANASAL SINUSES OTORHINOLARYNGOLOGY
Saint Louis University
Dr. Adaci
School of Medicine
02.28-03.05.2022

Ø Drainages:
• Inferior meatus: nasolacrimal duct
• Middle meatus: maxillary sinus, frontal sinus, anterior
ethmoid sinuses
• Superior meatus: posterior ethmoid sinuses, sphenoid
sinus
• Sphenoethmoidal recess: sphenoid sinus

Figure 14. Blood supply of the nasal septum

NERVE SUPPLY OF THE NASAL SEPTUM

Ø CN I – Olfactory nerve
Ø Trigeminal nerve
• Ophthalmic division – nasociliary nerve
• Maxillary branch – nasopalatine nerve, anterior superior
Figure 17. Lateral walls of the nasal cavity
alveolar nerve
E. MUCOSAL LINING OF NASAL CAVITY
Ø Vestibule
• Keratinized stratified squamous epithelium containing
sebaceous glands, sweat glands, and short, curved hair
called vibrissae
Ø Olfactory region
• Specialized olfactory epithelium. Present in the olfactory
cleft, which occupies the area between the superior
turbinate, cribriform plate, and the corresponding area of
the septum.
Ø Respiratory region
• Ciliated pseudostratified columnar epithelium with goblet
cells.
• It lines the lower 2/3 of the nasal septum, the lateral wall
of the nose below the superior turbinate, and the floor of
the nasal cavity.
• It extends into the sinuses through their Ostia and is
Figure 15. Nerve supply of the nasal septum thinner there.
• It is also continuous with the epithelia of the nasolacrimal
D. LATERAL WALL OF THE NASAL CAVITY duct and Eustachian tube.
Ø Marked by 3 projections called turbinate or concha
• Superior turbinate
• Middle turbinate
• Inferior turbinate
Ø The space between each turbinate/concha and the wall is called
a meatus
Ø Meatal opening functions for drainage
IV.

Figure 18. Mucosal lining of the nasal cavity

Figure 16. Nasal conchae and meati F. POSTERIOR NASAL OPENING

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 [UNIT 6]: M.01 ANATOMY OF THE NOSE AND PARANASAL SINUSES
Dr. Adaci
02.28-03.05.2022
Ø Choanae (Posterior Nasal Aperture) – 2 oval openings at the
back of the nose that communicates the nasal cavity with the
nasopharynx.
I.
IV.
Figure 19. Posterior nasal opening
G. BLOOD SUPPLY TO THE NASAL CAVITY
Ø From branches of the maxillary artery, one of the terminal
branches of the external carotid artery.
Ø The most important branch is the sphenopalatine artery.
Ø The sphenopalatine artery anastomoses with the septal branch
of the superior labial branch of the facial artery in the region of
the vestibule.
Ø The submucous venous plexus is drained by veins that
accompany the arteries.
Ø Woodruff’s plexus:
• The most common site of posterior epistaxis
• Posterior end of inferior and middle turbinate
• Sphenopalatine artery anastomoses with posterior
pharyngeal artery
• Common site of posterior epistaxis
Figure 20. Blood supply to the nasal cavity
H. NERVE SUPPLY TO THE NASAL CAVITY
Ø The olfactory nerves from the olfactory mucous membrane
ascend through the cribriform plate of the ethmoid bone to the
olfactory bulbs.
Ø The nerves of ordinary sensation are branches of the
ophthalmic division (V1) and the maxillary division (V2) of the
trigeminal nerve.
Barasona, Prangan, Cezar
OTORHINOLARYNGOLOGY
Saint Louis University
School of Medicine
Figure 21. Nerve supply to the nasal cavity
LYMPH DRAINAGE TO THE NASAL CAVITY
Ø The lymph vessels draining the vestibule end in the
submandibular nodes.
Ø The remainder of the nasal cavity is drained by vessels that
pass to the upper deep cervical nodes.
PARANASAL SINUSES
Ø Air filled cavities found in the interior of the maxilla, frontal,
sphenoid, and ethmoid bones
Ø Lined with mucoendosteum continuous with the respiratory
nasal mucosa
• Lined with a thin layer of ciliated pseudostratified
columnar epithelium with goblet cells which are
continuous with the respiratory mucosa of the nasal cavity
Ø Develop mostly after birth, and their degree of development
varies greatly
• Maxillary and ethmoid sinus- Develop on the 3rd and 4th
month AOG and are usually present at birth
• Sphenoid and Frontal- usually absent at birth
• All but the sphenoid sinus present as outpouchings of the
mucosa during embryonic life, but except for the ethmoid
air cells, they do not develop into bony cavities until after
birth
• The Frontal and sphenoid sinus reach their definitive size
in the first decade of life.
Figure 22. Paranasal Sinuses
Ø Sinuses develop as outgrowths from the nasal cavity; hence
they all drain directly or indirectly into the nasal cavity through
the meatus
• Maxillary sinus, anterior ethmoidal sinuses, Frontal sinus-
Drain to the nasal cavity through the middle meatus
• Posterior ethmoid sinus and Sphenoid- Drain into the nasal
cavity through the superior meatus
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 [UNIT 6]: M.01 ANATOMY OF THE NOSE AND PARANASAL SINUSES
Dr. Adaci
02.28-03.05.2022
Figure 23. Frontal sinus (yellow arrow) and Maxillary sinus (red arrow)
DRAINAGE OF MUCUS AND FUNCTION OF PARANASAL SINUES
Ø The mucus produced by the mucous membrane located within
the paranasal sinuses is moved into the nose by ciliary action
of the columnar cells
Ø Drainage of the mucus is also achieved by the siphon action
created during the blowing of the nose
A. MAXILLARY SINUS
Ø Aka Antrum of Highmore
Ø Pyramidal in shape
Ø Largest of the sinuses, with an average capacity of 15 ml in the
adult
Ø Paired and symmetric
Ø Present at birth but remains very small until the second
dentition
• Presence of tooth germs in the maxilla limit the extent of
the sinuses
Ø Located within the body of the maxilla behind the skin of the
cheek
Ø Drains into the middle meatus by means of the semilunar hiatus
Ø Roof is formed by the floor of the orbit
Ø Floor is formed by the alveolar process and hard palate
• Closely related to the roots of the second premolar and
first molar teeth creating a potential route for the spread
of dentogenic infections, and a tooth extraction may create
a communication between the oral cavity and maxillary
sinus (oroantral fistula)
Ø Behind the Maxillary sinus is the pterygopalatine fossa, which is
traversed by the maxillary artery along with the branches of the
trigeminal nerve and autonomic nervous system
Ø First sinus to develop in-utero (together with the ethmoid sinus)
and is filled with fluid at birth
Figure 24. Maxillary Sinus
Barasona, Prangan, Cezar
OTORHINOLARYNGOLOGY
Saint Louis University
School of Medicine
Figure 25. Maxillary Sinus (Coronal View)
Sinuses appear as radiolucency because they are air filled while bone
structures appear as radio opacities
Ø Yellow dot: Maxillary Sinus
Ø Red Double headed arrow: Nasal Septum
Ø Red dot: Inferior Turbinate
Ø Blue dot: Middle Turbinate
Ø Yellow arrow: Ethmoid Sinuses
Ø Red Circle: Portion of Frontal Sinus
Ø Blue Double headed arrow: Floor of the orbit
Ø Green Arrow: Anterior Maxillary wall
Figure 26. Para axial Sinus (Axial View)
Ø Red arrow: Anterior Maxilla
Ø Yellow arrow: Part of Nasal bones
Ø Orange arrow: Maxillary bone
Ø Blue double headed arrow: Nasal Septum
Ø Green Arrow: Lateral wall of the Maxillary sinus
Ø Blue arrow: Medial Wall of Maxillary Sinus
Ø Red Circle: If you compare left sinus from right sinus, You
will notice radio opacity within the maxillary sinus. This may
represent mucosal thickening or secretions that has
accumulated within the sinuses.
Figure 27. Maxillary Sinus (Sagittal View)
Ø Red arrow: Anterior wall of maxila
Ø Blue arrow: Posterior wall
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 [UNIT 6]: M.01 ANATOMY OF THE NOSE AND PARANASAL SINUSES OTORHINOLARYNGOLOGY
Saint Louis University
Dr. Adaci
School of Medicine
02.28-03.05.2022

Ø Green Arrow: Nasopharynx going down to pharnyx

Ø Yellow Arrow: Orbit
Ø Orange arrow: Alveolar process
Ø Purple Arrow: Hard palate
Ø Red dot: Mandible
Ø Blue Dot: Maxillary sinus

B. FRONTAL SINUS

Figure 28. Frontal Sinus Figure 30. Paranasal Sinus (Axial View)
Ø Red double headed Arrow: Anterior Frontal bone
Ø Rarely symmetrical, each roughly triangular Ø White arrow: Frontal sinuses
Ø Contained within the frontal bone
Ø Separated from each other by a bony septum that is usually
deviated to one side such that your frontal sinuses are rarely
symmetrical, each roughly triangular
Ø Extends upward above the medial end of the eyebrow and
backward into the medial part of the roof of the orbit
Ø Drains into the middle meatus directly or indirectly thru the
frontonasal duct, which opens into the frontal recess or
ethmoidal infundibulum which will eventually drain into your
middle meatus
Ø Formed by the upward movement of anterior ethmoid cells after
the age of 2
Ø Developmentally, this is the last sinus to pneumatize
• Still absent at birth
Ø Growth increases at age 6 years and continues until the late
teenage years
Ø Inflammations to the frontal sinus can give rise to serious
complications because its close proximity to the orbit and
cranial cavity (Orbital cellulitis, Epidural or subdural abscesses, Figure 31. Paranasal Sinus (Sagittal View)
meningitis) Ø Red arrow: Frontal Bone continuous with the
Ø Blue arrow: Nasal Bone
Ø Red dot: Frontal Sinus
Ø Blue dot: Ethmoid sinuses
Ø Green Dot: Sphenoid Sinus
Ø Green arrow: Nasopharynx

C. SPHENOID SINUS

Figure 29. Paranasal Sinuses (Coronal View)

Ø Yellow arrow: Orbit
Ø Red Arrow: Maxillary Sinus
Ø Blue arrow: Nasal Septum
Ø Red Circle: Frontal sinuses

Figure 32. Sphenoid Sinus

Ø Lie within the body of the sphenoid bone which is located at the
base of the skull
Ø Average capacity is about 7 ml in the adult

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 [UNIT 6]: M.01 ANATOMY OF THE NOSE AND PARANASAL SINUSES OTORHINOLARYNGOLOGY
Saint Louis University
Dr. Adaci
School of Medicine
02.28-03.05.2022

Ø Right and left sinuses are rarely symmetrical, separated by a Ø Green rectangle: Ethmoid sinuses
septum, which may be deficient in part and is often oblique Ø Sphenoid sinus
Ø Ostium of sphenoid sinus is situated in the upper part of the Ø Red arrow: Nasopharynx
anterior wall of the sinus which communicates with the superior
meatus indirectly through the sphenoethmoidal recess. D. ETHMOID SINUSES
Ø The drainage is through the sphenoethmoidal recess before it
eventually drains into the superior meatus
Ø Borders
• Superior: Sella turcica and pituitary and by the anterior and
middle cranial fossae
• Posterior wall: clivus
• Relates laterally: caverrnous sinus, Internal carotid artery,
CN II-VI and very closely related to the optic canal

Figure 36. Ethmoid Sinuses

Ø Consists of a number thin-walled cavities (approximately 7-15)

divided into anterior, middle (small and numerous) and
posterior (large and few) ethmoid cells
Ø Contained within the ethmoid bone, between the nose and the
orbit
Ø Anterior and middle
• Small and numerous
• drains into middle nasal meatus
Ø Posterior
• Large and few
Figure 33. Coronal View
• drains into superior nasal meatus
Ø Red Circle: Sphenoid sinus Ø Separated from the orbit by the lamina papyracea
Ø Red Rectangle: Nasopharynx
• Lamina Papyracea – a paper thin plate of bone that easily
Ø Red arrow: Brain
fractures; forms most of the medial wall of the orbit
Ø Blue arrow: Skull
Ø Due to its thinness, Infection can readily spread from the
sinuses into the orbit
Ø Ethmoid cells may invade any of the surrounding bones
Ø A labyrinthine system of small, pneumatized sinus cavities that
are separated from one another by thin bony walls
Ø Superior and medial to the maxillary sinus
Ø Extend posteriorly between the middle turbinate (medial border)
and orbit to the sphenoid sinus

Figure 34. Paranasal Sinus (Axial view taken at level of orbit)

Ø Red arrow: Orbit
Ø Green arrow: Nasal bone
Ø Blue double headed arrow: Nasal Septum
Ø E: Ethmoid sinuses
Ø M: Maxillary sinus
Ø S: Sphenoid sinus (Posteriorly)
Figure 37. Ethmoidal Sinuses (Coronal View)
Ø Red arrow: Orbit
Ø Blue arrow: Lamina papyracea
Ø Ethmoid air cells

Figure 35. Paranasal Sinus (Sagittal view)

Ø Frontal sinus

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 [UNIT 6]: M.01 ANATOMY OF THE NOSE AND PARANASAL SINUSES OTORHINOLARYNGOLOGY
Saint Louis University
Dr. Adaci
School of Medicine
02.28-03.05.2022

b. HALLER CELLS
Ø Also known as
infraorbital
ethmoidal air cells,
they are ethmoid air
cells located lateral
to the maxillo-
ethmoidal suture
and along the
inferomedial orbital
floor

Figure 41. Haller Cell (White arrowhead)

MS: Maxillary Sinus
Figure 38. Ethmoid Sinuses (Axial View) Red arrow: Maxillary ethmoidal suture line
Ø Green dot: Orbit Blue arrow: inferomedial orbital floor, locate
Ø Red arrow: Nasal bones in here is you Haller cells
Ø Rectangle: Ethmoid sinuses
c. ONODI CELL
Ø A posterior ethmoid
air cell that lies
superior to the
sphenoid sinus

Figure 42. Onodi Cell

Rectangle: Nasal Cavity
S: Sphenoid sinus
O: Onodi cell

d. ETHMOID BULLA
Figure 39. Ethmoidal Sinuses (Sagittal View)
Ø One of the important
• Hiatus semilunaris (left arrow), drainage passage of landmarks of your
posterior ethmoid cells (arrow at right), and middle and sinuses is your
inferior turbinates (asterisks) ethmoid bulla
Ø Largest anterior
ETHMOID AIR CELLS ethmoid air cell. It is
a. AGGER NASI CELLS also one of the most
Ø Anterior ethmoidal consistent air cells
air cells lying in the middle
anterolateral and meatus and is
inferior to the frontal therefore a reliable
recess and anterior anatomic landmark
and above the Figure 43. Ethmoid Bulla
attachment of
Red dot: Orbit
middle turbinate
MT: Middle turbinate
EB: Ethmoid bulla

E. BLOOD SUPPLY OF PARANASAL SINUSES

PARANASAL SINUS BLOOD SUPPLY
Figure 40. Agger Nasi Cell Frontal sinus Supraorbital and Supratrochlear (divisions
Red arrow: Frontal sinus of the ophthalmic artery)
Blue arrow: Frontal recess Ethmoid sinus Sphenopalatine and Anterior and Posterior
MT: Middle turbinate ethmoidal arteries (arise from the
IT: Inferior turbinate ophthalmic artery)
At each attachment, just below the frontal Sphenoid sinus Posterior ethmoidal arteries and
recess is your Agger Nasi Cell sphenopalatine artery
Maxillary sinus Superior alveolar and Infraorbital arteries
(divisions of maxillary artery)

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 [UNIT 6]: M.01 ANATOMY OF THE NOSE AND PARANASAL SINUSES OTORHINOLARYNGOLOGY
Saint Louis University
Dr. Adaci
School of Medicine
02.28-03.05.2022

Ø Detailed knowledge of the vascular supply is particularly
important in the management of intractable epistaxis
(nosebleed), which requires vascular ligation or angiographic
embolization as a last recourse
V. OSTEOMEATAL COMPLEX
ØFunnel shaped passage through which secretions are
transported into the middle meatus from various anterior
ethmoid air cells and maxillary sinus
D. HIATUS SEMILUNARIS
Ø Crescent shaped gap between the posterior free margin of the
uncinate process and the anterior wall of the ethmoid bulla
E. FRONTAL RECESS
Ø Most anterior and superior aspect of the anterior ethmoid sinus
that forms a connection with the frontal sinus

Figure 44. Osteomeatal Complex

ØRed dot: Orbit

ØRed arrow: Nasal Septum Figure 45. Osteomeatal Complex. Sagittal CT Image of the Paranasal
ØInferior turbinate: on the lateral wall of nasal cavity or on the Sinuses showing the frontal recess. This is your frontal sinus (red arrow),
medial wall of maxillary sinus this is your frontal infundibulum (red rectangle) going down into your
Ø Inferior meatus: beneath the inferior turbinate frontal recess (blue rectangle) into the middle meatus
Ø Middle turbinate: superior to the inferior turbinate
Ø Middle meatus: beneath middle turbinate F. MAXILLARY SINUS
Ø Blue arrow: Uncinate process - A hook-like structure forming the G. MIDDLE TURBINATE
medial wall of maxillary sinus and anterior wall of hiatus H. MIDDLE MEATUS
semilunaris
Ø Ethmoid Bulla: The largest anterior ethmoid air cell CHECKPOINT
Ø Green arrow: Infundibulum: funnel-shaped passageway from 1. T/F: Skin of the external nose is supplied by branches from the facial
the maxillary sinus artery, which comes from the external carotid artery
Ø Blue dot: Hiatus semilunaris – opening going into the middle 2. T/F: Maxillary and ethmoid sinus- Develop on the 7th and 8th month
meatus AOG and are usually present at birth
Ø AKA ostiomeatal unit 3. It is a muscle group that is useful during nasal flaring.
Ø Functional concept rather than an anatomic structure 4. It is an area with the highest nasal airway resistance.
identifying the final common pathway for mucociliary drainage 5. This plexus is the most common cause of anterior epistaxis.
and ventilation of ethmoid, maxillary and frontal sinuses 6. The most common site of posterior epistaxis
Ø Goal of naming this area as a unit not to identify a certain 7. It is pyramidal in shape and the largest of the sinuses having an
anatomic structure but to emphasize the concept that average capacity of 15 ml in the adult.
inflammation in any area of the OMC can lead to anatomic and 8. It is the deepest portion at the root of the nose which usually
functional obstruction of anterior sinuses. corresponds to the nasofrontal border of the nasal bone.
Ø Any of these cells, clefts, ostia, recesses or cavities may be 9. It is the most inferior margin of the nasal septum.
affected by a pathological process, thereby contributing to the 10. It is the space between each turbinate/concha and the wall
symptoms and pathophysiology of sinusitis
Ø The osteomeatal unit is bounded medially (toward the nasal Meatus 10.
cavity) by the middle turbinate and laterally by the lamina Columella 9.
papyracea
Ø Composed of the following:
Sellion/radix 8.
• Maxillary sinus
Maxillary sinus 7.
• Ethmoid infundibulum
Woodruff’s plexus 6.
• Hiatus semilunaris
Kiesselbach’s plexus/Little’s area 5.
• Middle turbinate
Nasal Valve 4.
• Middle meatus
Dilator Muscle Group 3.
• Uncinate process
AOG and are usually present at birth.
• Ethmoid bulla
2. F. Maxillary and ethmoid sinus- Develop on the 3rd and 4th month
• Frontonasal/ Frontal recess external carotid artery
VI. ophthalmic and the maxillary arteries, which comes from the
A. UNCINATE PROCESS 1. F: Skin of the external nose is supplied by branches of the
Ø Hook-like structure forming the anterior boundary of the hiatus ANSWERS
semilunaris and medial wall of ethmoid infundibulum
B. ETHMOID BULLA
Ø Most constant and largest of the anterior ethmoid cells located
within the middle meatus and posterior to the uncinate process
VII.
C. ETHMOIDAL INFUNDIBULUM

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