PARANASAL SINUSES

PRESENTED BY DEPARTMENT OF RADIODIAGNOSIS AND IMAGING

Paranasal sinuses
The paranasal sinuses are air containing bony spaces around the nasal cavity lined by mucus membrane of ciliated columnar epithelium. It arises as outgrowth of nasal cavity by invading neighbouring bone at expense of diploic space. There are traces of maxillary and sphenoid sinus in the neonate rest will evidient about the age of 7-8 yrs. They only become fully developed in adolsence. There are 4 pairs of sinuses . 1.frontal sinus. 2.ethmoidal sinus. 3.Maxilary sinus. 4.Sphenoid sinus.

Imaging methods
1. X-ray 2. CT Scan 3. MRI

Recommended projection(X-ray)
1. Occipital-mental view with open mouth. 2. Occipito-frontal 15 degree caudal. 3. Lateral view.

SINUSES
om view

6 4

1. Nasal Septum 2. Frontal Sinus 3. Maxillary Sinus 4. Ethmoid Sinus 5. Inferior Turbinate 6.Superior orbital fissure
3

AP WATERS VIEW
1
10

SINUSES
1. Frontal sinus 2. Ethmoid Sinus 3. Nasal Septum (bony) 4. Zygomatical-Frontal Suture 5. Maxillary Sinus 6. Zygoma 7. Zygomatic Arch 8. Mandible 9. Inferior orbital margin 10. Left orbit

2 4 3 5

11 1

3 5 7

1. Frontal Sinus 2. Maxillary Sinus 3. Ethmoid Sinus 4. Spenoid Sinus 5. Sella Turcica 6. Occipital Bone 7. Mastoid Air Cells 8. Floor of posterior fossa 9. Anterior arch of C-1 10. Mandible 11.Coronal Suture

2
4

6 9 10 8

Lateral Sinus & Skull

Frontal sinus
It is asymmitrical,paired cavity between the table of frontal bone. The shape and size of frontal sinus is heighly variable. Each sinus communicate with the middle meatus of nose through the ethmoid infundibulum and hiatus semilunaris via fronto-nasal duct.

CT- SINUS
AXIAL VIEW

1. Frontal Sinus

CT- SINUS
CORONAL VIEW

1. Fronto-nasal suture 2. Frontal sinus 3. Nasal bones

1

Ethmoidal sinus
It comprises group of thin walled air cells within the ethmiod labyrinth. They are vary in size and about 3 18 in number. They are divided into threre group Anterior group:3-7 in numbers , open in the middle meatus through the ethmoidal infundibulum and hitussemilunaris.

CT- SINUS
AXIAL VIEW

1. Ethmoid Sinus 2. Sphenoid Sinus 3. Carotid canal

1

2 3

CT- SINUS
CORONAL VIEW
1

1. Ethmoid sinus 2. Inferior turbinate 3. Middle turbinate

Ethmoidal sinus
Middle group: 1-3 in no s . the ethmoid bulla contains the largest and most constant of middle ethmoid cells. Drains into middle meatus. Posterior group:1-11 no s. it drains into superior meatus.

Maxillary sinus
These are pyramidal shape the largest of paranasal sinuses and contained within the maxilary body. Boundary: Apex: by zygomatic process of maxilla. Base: nasal surface of body of maxilla. Roof: floor of orbit. Floor : alveolar process of maxilla . the roots of premolar and molar teeth may project into sinus but usually separated by thin layer of bone and mucosa.

CT- SINUS
AXIAL VIEW

1 4

1. Maxillary Sinus 2. Med. & Lat. Pterygoid plate 3. Nasopharyn x 4. Nasal septum 5. Inferior turbinate

CT- SINUS
CORONAL VIEW

1. Maxillary sinus 2. Nasal Septum

2

Maxillary sinus
Maxillary sinus drain into meddle meatus through floor of hitus semilunaris , and the opening lies just below the bulla ethmoidalis via maxillary ostium. Osteomeatal complex : it refers to maxillary sinus osteum ,ethmoid infundibulum , hiaus semilunaris and frontal recess . it is the common final pathway for drainage of secretion from maxillary , ant and middle ethmoid sinuses into middle meatus.

18

Sphenoid sinus
These paired sinuses are located within body of sphenoid bone. Relation: Above : optic chaisma and hypophysis cerebri. Below : roof of nasophrynx. On each side : cavernous sinus and internal carotid artery

CT- SINUS
AXIAL VIEW

1. Ethmoid Sinus 2. Sphenoid Sinus 3. Carotid canal

2 3

CT- SINUS
CORONAL VIEW

1. Sphenoid sinus 2. Hard Palatte

Sphenoid sinus

Each sinuses drains into the spheno-ethmoidal recess .

Function of Paranasal Sinuses

Humidifying and warming inspired air Regulation of intranasal pressure Increasing surface area for olfaction Lightening the skull Resonance

23