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Anatomy of Nose &

Paranasal Sinuses
Supervisor: dr. Oscar Djauhari, Sp.THT-KL
Presented by:
Randi Suharlian
Catherine Halim
Josephine Christy
Clerkship of Ear Nose Throat Head and Neck Department
Regional Hospital R. Syamsudin SH
External Nose
External Nose

Pyramidal shape
Skeleton partly bony and partly cartilaginous and
Nasal bone
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
External Nose

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 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
The lateral nasal wall nasal turbinates
The meatus are situated below the corresponding
Lateral nasal wall.
1. frontal sinus; 11. soft palate;
2. middle nasal concha; 12. pharyngeal recess;
3. middle nasal meatus; 13. eustachian tube orifice;
4. agger nasi; 14. torus tubarius;
5. atrium of middle nasal concha; 15. adenoid;
6. limen; 16. sphenoid sinus,
7. vestibule; 17. sphenoid sinus opening;
8. inferior nasal meatus; 18. sphenoethmoidal recess;
9. incisive canal; 19. inferior nasal concha;
10. palatine process of maxilla; 20. superior nasal meatus;
21. uperior nasal concha;
22. palatine bone.
Nasal septum.
1. Perpendicular plate; 11. perpendicular plate;
2. cribriform plate; 12. postnasal spine;
3. crista galli; 13. horizontal plate;
4. frontal bone; 14. lateral pterygoid plate;
5. nasal bone; 15. medial pterygoid plate;
6. septal cartilage; 16. sphenoid sinus;
7. medial crus; 17. crest;
8. anterior nasal spine; 18. body.
9. incisive canal;
10. palatine process;
Blood Supply of Nasal Cavity
The arterial supply is from:
Internal carotid sources through the anterior and posterior ethmoid
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
Type of Paranasal Sinuses
Frontal sinus
Ethmoid sinus
Maxillary sinus
Sphenoid sinus
Anatomy of Paranasal Sinuses

Paranasal sinuses are

mucosa-lined structures
continuous with the
nasal cavity
Frontal Sinuses

Located in the frontal bone

Its 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
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 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.
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 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 floor of the sinus is the alveolar process
The 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 Meatus media Meatus inferior

Located below the superior Located between the Situated below the
turbinate and above the medial turbinate and inferior turbinate
medial turbinate inferior turbinate The biggest meatus
Drainage the posterior Drainage the frontal An orifice of the
ethmoid sinuses and sinus, maxillary sinus, ipsilateral naso-
sphenoid sinus and anterior ethmoid lacrimal duct.
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 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
Ethmoidal bullae
Uncinate process
Hiatus semilunaris
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

Fonetic function
Static and mechanic function lightening the weight
of facial skeleton, protection
Nasal reflex