OTORHINOLARYNGOLOGY

IS A CLINICAL SURGICAL DISCIPLINE, WHICH STUDIES MORPHOLOGY,

PHYSIOLOGY AND PATOLOGY OF EAR, UPPER AIRWAYS AND ADJACENT
REGIONS

LATIN NAME FORMS FROM: ENGLISH NAME – ENT diseases:

OTOS EAR
RHINOS NOSE
LARYNX THROAT
LOGOS

1
Connection with other disciplines
neurology
neurosurgery

ophthalmology
 dentistry
therapy
Infectious disease
dermatology
allergology
immunology
 Nasal cavity - an initial part of a respiratory tract
Nasal cavity walls:
- Medial (septum nasi)
- Top (tegmen)
- Bottom (fundus)
- lateral (external)
- anterior (nostrils)
- posterior (choanae)
Three nasal turbinates
(conchae):
- superior turbinate
- middle turbinate
- inferior turbinate

Three nasal meatuses:

- superior nasal meatus
- middle nasal meatus
- inferior nasal meatus
Nasal cavity areas:
- Respiratory
(regio respiratoria)
from the fundus
up to superior
edge of the middle
nasal conchae

- olfactory (regio olfactoria)

a medial surface
of the middle nasal conchae
and superior nasal meatus area
Ostiomeatal complex is a part of the ethmoidalis bone and represents
the system of courses and apertures in the area of anterior parts of the
middle masal meatus
Ostiomeatal complex
Nasal valve is specific triangular rimous (slit-like) formation
between the lateral cartilage in place of its attachment to
septum nasi and the septum itself

The nasal valve angle

is an angle between the lateral cartilage and the septum nasi
The respiratory area is covered with multirow (pluriseral)
cylindric ciliary epithelium which contains:

1. Ciliary cells

2. Goblet cells

3. Basal cells

The ciliary cell has 300 cilia on the top

Speed of the cilia beat is 60-1200 times a minute
Mucociliary transport system
Cilia are covered with mucus (secretion of mucous and serous
glands, goblet cells)
Ciliary cells, cilia and mucus form mucociliary transport system,
which conduct the nasal cavity clarification

Mucociliary clearance is the first protection line.

It prevents fixation of an alive or dead antigenic material on the
surface of mucous membrane and its penetration inside
The basic membrane (reticular and collagenic fibres)
divides the mucous membrane of the nasal cavity into
two layers:

- Epithelial

- Lamina propria
The second line of protection provides local immunity:
Mucus contains nonspecific and specific factors of protection

It carries out the next functions:

- recognition
- inactivation
- destruction
- neutralization
- removing the foreign antigenic material lasted
through the epithelium
Nasal cavity functions:

1. Respiratory
2. Protective
3. Reflex
4. Conditioning
5. Information
6. Secretory
7. Aspirating
8. Olfactory
While passing the nasal cavity the air is:
- cleared
- warmed
- humidified
- neutralized
Inhalation is an air stream along the middle nasal conchae
(turbulent movement)
60% of pathogenic microflora settle down in the nasal cavity
and is neutralized there
Exhalation is an air stream along the inferior nasal conchae
through the choanae (the ostia is in 3-4 times more than the
nasal valve ostia)
 Reflex function

3 groups of reflexes are distinguished:

I. Intranasal (thorns, crests)
II. Arise in the nasal cavity, influence the function of the remote
organs (trigeminal nerve neuropathy, bronchial asthma)
III. The irritation in other organs causes changes in the nasal
cavity (cooling, pregnancy)
 Conditioning function
(air humidifying and warming)

500 ml of a liquid are allocated in the nasal cavity every day

Thermoreceptors of cold and heat influence the cavernous

venous plexuses
 Information function

- Nasal cavity mucosa is constantly bombarded by an antigenic

material
- Epithelial cells are antigenpresenting
- The nasal cavity informs an organism on antigenic structure of
the environment
Mucociliary transport system research
Mucociliary transport system research
Anterior rhinoscopy
Posterior rhinoscopy