Anatomy of Nose &

Paranasal Sinuses
Supervisor:
dr. Oscar Djauhari, Sp.THT-KL

Presented by:
Syaepul Firdaus (2011730107)

Clerkship of Ear Nose Throat Head and Neck Department

Regional Hospital R. Syamsudin SH
Period 2015, 6th July 15th August
External Nose
Pyramidal shape
Skeleton partly bony and partly cartilaginous and
membranous
Nasal bones
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 maxilla
External Nose (2)
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 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 bone.

The lateral nasal wall nasal turbinates

The meatus are situated below the corresponding
turbinates
Lateral nasal wall. 1. frontal sinus; 2. middle nasal concha; 3. middle nasal
meatus; 4. agger nasi; 5. atrium of middle nasal concha; 6. limen; 7. vestibule;
8. inferior nasal meatus; 9. incisive canal; 10. palatine process of maxilla; 11. s0ft
palate; 12. pharyngeal recess; 13. eustachian tube orifice; 14. torus tubarius; 15.
adenoid; 16. sphenoid sinus, 17. sphenoid sinus opening; 18. sphenoethmoidal
recess; 19. inferior nasal concha; 20. superior nasal meatus; 21. superior nasal
concha; 22. palatine bone.
Nasal septum. 1, Perpendicular plate; 2, cribriform plate; 3, crista galli; 4,
frontal bone; 5, nasal bone; 6, septal cartilage; 7, medial crus; 8, anterior nasal
spine; 9, incisive canal; 10, palatine process; 11, perpendicular plate; 12,
postnasal spine; 13, horizontal plate; 14, lateral pterygoid plate; 15, medial
pterygoid plate; 16,sphenoid sinus; 17, crest; 18, body.
Blood Supply of Nasal Cavity
The arterial supply is from:
Internal carotid sources through the anterior and
posterior ethmoid arteries
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 nosebleeds.
Type of Paranasal Sinuses
Frontal sinus
Ethmoid sinus
Maxillary sinus
Sphenoid sinus
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
Meningitis

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.
Borders:
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
Border:
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
Located below the superior turbinate and above the medial
turbinate
Drainage the posterior ethmoid sinuses and sphenoid sinus
Meatus media
Located between the medial turbinate and inferior turbinate
Drainage the frontal sinus, maxillary sinus, and anterior
ethmoid sinus
Meatus inferior
Situated below the inferior turbinate
The biggest meatus
An orifice of the ipsilateral naso-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
Infundibulum
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
Smelling
Fonetic function
Static and mechanic function lightening the weight
of facial skeleton, protection
Nasal reflex
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