Paranasal Sinus Anatomy pot

Paranasal
Paranasal
Sinus
Sinus
Anatomy
Anatomy
Marilene B. Wang, MD,
Marilene B. Wang, MD,
FACS
FACS
Professor
Professor
UCLA Division of Head and Neck
UCLA Division of Head and Neck
Surgery
Surgery
Chief of Otolaryngology
Chief of Otolaryngology
VA Greater Los Angeles Healthcare
VA Greater Los Angeles Healthcare
System
System
Paranasal
Paranasal
Sinus Function
Sinus Function


Lining
Lining
–

–
pseudostratified
pseudostratified
ciliated columnar epithelium
ciliated columnar epithelium


Mucous and
Mucous and
serosanguinous
serosanguinous
glands
glands


Parasympathetic and
Parasympathetic and
sympathetic
sympathetic
innervation
innervation
Paranasal
Paranasal
Sinus Function
Sinus Function


Mucous blanket renewed every
Mucous blanket renewed every
10

10
-
-
15 minutes
15 minutes


Warm and humidify air
Warm and humidify air


Secrete
Secrete
immunoglobulins
immunoglobulins
,
,
interferons
interferons
, inflammatory cells
, inflammatory cells
Paranasal
Paranasal
Sinus Function
Sinus Function


Cilia beat 10
Cilia beat 10
-

-
15 times/second
15 times/second


Cilia function varies with
Cilia function varies with
environment, allergies, smoking,
environment, allergies, smoking,
etc.
etc.


Mucociliary
Mucociliary
system
system
—
—
cleanse sinus,
cleanse sinus,
immunoprotective
immunoprotective


Move mucous to natural
Move mucous to natural
ostia
ostia
of

of
sinuses
sinuses
Four Paired Sinuses
Four Paired Sinuses


Ethmoid
Ethmoid


Maxillary
Maxillary


Frontal
Frontal


Sphenoid
Sphenoid
Ethmoid
Ethmoid
Sinus
Sinus


Greatest anatomic variation
Greatest anatomic variation



Pyramidal shape with base
Pyramidal shape with base
posteriorly
posteriorly


4
4
-
-
5 cm length A
5 cm length A
-
-
P
P


2.5 cm height
2.5 cm height


0.5 cm wide
0.5 cm wide
anteriorly
anteriorly



1.5 cm wide
1.5 cm wide
posteriorly
posteriorly
Ethmoid
Ethmoid
Sinus
Sinus


Numerous small air cells
Numerous small air cells


Filled with fluid at birth
Filled with fluid at birth


Visualized at 1 year of
Visualized at 1 year of
age
age
Ethmoid
Ethmoid
Sinus
Sinus


Roof

Roof


fovea
fovea
ethmoidalis
ethmoidalis


Lateral wall
Lateral wall
—
—
lamina
lamina
papyracea
papyracea


Average 9 air cells
Average 9 air cells


Anterior group
Anterior group


Posterior group
Posterior group
Anterior

Anterior
Ethmoid
Ethmoid
Cells
Cells


Frontal recess
Frontal recess


Infundibular
Infundibular


Bullar
Bullar


Conchal
Conchal


Agger
Agger
nasi
nasi
Posterior
Posterior

Ethmoid
Ethmoid
Cells
Cells


Onodi
Onodi
cells
cells
—
—
surrounding optic
surrounding optic
nerve within sphenoid bone
nerve within sphenoid bone


Posterior
Posterior
ethmoid
ethmoid
artery
artery
—
—
junction
junction
of fovea
of fovea

ethmoidalis
ethmoidalis
and frontal
and frontal
bone, anterior to optic nerve
bone, anterior to optic nerve


Anterior
Anterior
ethmoid
ethmoid
artery
artery
—
—
dome of
dome of
ethmoid
ethmoid
posterior to frontal recess
posterior to frontal recess
Middle Turbinate
Middle Turbinate


Conchal
Conchal

cell (
cell (
concha
concha
bullosa
bullosa
)
)


Attached superiorly to the
Attached superiorly to the
cribriform
cribriform
plate
plate
Middle Turbinate
Middle Turbinate


Attached to
Attached to
ethmoid
ethmoid
capsule and lamina
capsule and lamina
papyracea
papyracea
by basal lamellae
by basal lamellae



Posterior end at
Posterior end at
sphenopalatine
sphenopalatine
foramen
foramen
Maxillary Sinus
Maxillary Sinus


Present at birth
Present at birth


Rapid growth age 0
Rapid growth age 0
-
-
3, then
3, then
7
7
-

-
12
12


Triangular shape
Triangular shape


Natural
Natural
ostium
ostium
superior
superior
medial wall
medial wall