The document discusses the paranasal sinuses and nose. It describes the functions and development of the paranasal sinuses, which are air-filled cavities around the nasal cavity. The sinuses resonate the voice, decrease skull weight, warm and moisten air, act as shock absorbers, and possibly help control the immune system. They develop from fetal sacs in the bones and nasal mucosa. The document outlines the maxillary, frontal, sphenoid, and ethmoid sinuses and their blood supply, nerve supply, and drainage pathways. It notes that sinusitis and polyps can cause inflammation and blockage in the sinuses.
2. Questions
1. Mention the functions of the nose
2. Name the components of nasal septum
3. Dangerous area of the face
4. Name the concha & meatus in the lateral
wall of nose
5. Sphenoidal air sinus is drained to ….
6. Blood supply and nerve supply of Nasal
septum
4. Paranasal Sinuses
• Air filled cavities located in the
bones around the nasal cavity
• Lined by respiratory mucosa which
is continuous with the mucosa of the
nasal cavity
• Drain into the nasal cavity through
relatively small apertures
• Drainage of the sinuses mainly
depends on the movement of the
cilia, which propel the mucus toward
their openings in the nasal cavity
5. Functions of Sinuses
– Resonating chamber for voice
– Decrease weight of skull
– Warm & moisten air
– Shock absorbers
– Immune system
• Sinuses are air containing cavities situated in the frontal,
ethmoidal and sphenoid bones of the cranium and the
maxillary b ones of the face. They are known as the paranasal
sinuses because of their formation from the nasal mucosa and
their continued communication with nasal fossas.
• These cavities serve five purposes:
• 1) Serve as a resonating chamber for the voice
• 2) Decrease the weight of the skull
• 3) Help wam and moisten inhaled air
• 4) Act as shock absorbers in trauma (like air bags in a car)
• 5) Possibly help control immune system.
8. The sinuses begin developing as a fetus and first appear as small sacculations of the mucosa of
the nasal meatus and recesses.
As the pouches or sacs develop and grow they gradually invade the respective bones to for air
sinuses and cells.
The maxillary sinuses are usually developed and aerated at birth and can be demonstrated
radiographically.
Sphenoid and frontal sinuses develop at approximately age 6-7 yrs. At this time they are
distinguishable from the ethmoid air cells.
The ethmoid air cells develop during puberty and develop slowly until approximately 17-18 years
of age.
When the sinuses are fully developed they communicate with each other and with the nasal
cavity.
17. Nerve supply
• Ant ethmoidal nerve
• Post etmoidal nerve
• Maxillary branch of trigeminal nerve
Lymphatics
• ant.& middle ethmoidal cells-submandibular group
• Post ethmoidal –retropharyngeal nodes
18. Pathologic Indications
• Inflammatory conditions:
– Sinusitis (Acute or Chronic)
– Secondary Osteomyelitis
• Sinus Polyps
• Trauma
• Sinusitis simply means your sinuses are infected or inflamed, but this gives little indication of the
misery and pain this condition can cause. Health care experts usually divide sinusitis cases into:
• Acute, which last for 3 weeks or less
• Chronic, which usually last for 3 to 8 weeks but can continue for months or even years
• Recurrent, which are several acute attacks within a year
• Symptoms of Sinusitis
• The location of your sinus pain depends on which sinus is affected.
• Headache when you wake up in the morning is typical of a sinus problem.
• Pain when your forehead over the frontal sinuses is touched may indicate that your frontal sinuses
are inflamed.
• Infection in the maxillary sinuses can cause your upper jaw and teeth to ache and your cheeks to
become tender to the touch.
• Other symptoms of sinusitis can include:
• Fever
• Weakness
• Tiredness
• A cough that may be more severe at night
• Runny nose (rhinitis) or nasal congestion
• In addition, the drainage of mucus from the sphenoid or other sinuses down the back of your throat
(postnasal drip) can cause you to have a sore throat. Mucus drainage also can irritate the
membranes lining your larynx (upper windpipe). Not everyone with these symptoms, however, has
sinusitis
19. Information from the National Institutes of Health
Secondary Osteomyelitis- an infection of the bone and
marrow secondary to sinusitis, results in erosion of the bony
margins of the sinus. It is can also be caused by chronic
cocaine usage.
• Polyps are tissue swellings within the nose and sinuses that
can be responsible for many of the symptoms described by
patients with rhinosinusitis. Polyps may simply block the
nasal airway creating difficulty in nasal breathing, or they may
block the proper drainage of the sinus cavities leading to
stagnant secretions within the sinuses that may become
infected.
• Polyps are generally thought to occur as a result of an ongoing
inflammatory process within the nose and sinuses. Although
this may be related to allergies, most cases of polyps occur as
a result of non-allergic processes.
• Whatever the cause, polyps can wreck havoc in the nose and
sinuses and make patients miserable. Common symptoms in
patients with nasal and sinus polyps include nasal obstruction,
decreased sense of smell, recurrent sinus infections, and
profuse nasal drainage. Many of these patients feel as though
they have a cold all of the time.
• Rhinisits: Inflammation of the nasal mucous membrane is
called rhinitis. The symptoms include sneezing and runny
and/or itchy nose, caused by irritation and congestion in the
nose. There are two types: allergic rhinitis and non-allergic
rhinitis.
20. Anterior Rhinoscopy
• To evaluate the nasal vestibule
and the anterior portions of the
nasal cavity
21. Posterior Rhinoscopy
• Posterior rhinoscopy was formerly done to evaluate
the nasopharynx and posterior nasal cavity (choanae,
posterior ends of the turbinates, posterior margin of
the vomer)
• Endoscopy is commonly used to examine this region
