Paranasal sinuses

Introduction

• Pneumatic bones

• Location

• Relation to nasal cavity

• Mucosa of sinuses

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Function of Paranasal Sinuses

• Humidifying and warming inspired air

• Regulation of intranasal pressure

• Increasing surface area for olfaction

• Lightening the skull

• Resonance

• Absorbing shock

• Contribute to facial growth

Paranasal sinuses

• 4 in no.

• Divisions – anterior & posterior

• Anterior- maxillary, frontal & anterior

ethmoidal sinuses

• Posterior – middle, posterior ethmoidal &

sphenoidal sinuses

Frontal sinus

• Shape

• Location

• Size & no

• Relations – anterior , floor , posterior

• Communications – to middle meatus directly

or frontonasal duct

• Blood supply

• Nerve supply

• Lymphatic drainage

Ethmoidal sinus

• Location

• Groups & no.

• Relations – roof , lateral wall

• Communications

• Blood supply

• Lymphatic drainage

Maxillary sinus

• Shape

• Location

• Size & no.

• Relations

• Communications

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Osteomeatal Complex Middle meatus

Maxillary Sinus Ostium

Anterior Ethmoid

Drainage

• Blood supply

• Nerve supply

• Lymphatic drainage

Sphenoidal sinus

• Location

• Size & no.

• Relations

• Communications

• Blood supply

• Nerve supply

• Lymphatic drainage

Applied anatomy

• Sinusitis – acute & chronic

• Neoplasms

Sinusitis

• Causes

• Clinical features

• Diagnosis

• Treatment – medical & surgical

• Complications

causes

• Obstruction to sinus ventilation & drainage

• Nasal infection

• Swimming & diving

• Trauma

• Dental infection

Maxillary sinusitis- Water’s ie

Clinical features

• Constitutional symptoms

• Headache

• Tenderness

• Oedema of eyelid

• Nasal discharge

• Postnasal discharge

Investigations

• X-ray – lateral & ater’s ie

• CT scan

• MRI

Water’s ie

Caldwell view

Lateral view

CT picture of sphenoidal sinus

Surgical Treatment

• Frontal sinusitis – Trephination of frontal sinus

- intranasal drainage operations

- external frontoethmoidectomy

( Ho arth’s or Lynch operation)

- osteoplastic flap operation

• Maxillary sinusitis – antral puncture &

irrigation

- intranasal antrostomy

- caldwell- luc operation

• Ethmoid sinusitis – external ethmoidectomy

- intranasal ethmoidectomy

• Sphenoidal sinusitis – sphenoidotomy

Sphenoidotomy Intranasal ethmoidectomy

Complications

1. Orbital complications

2. Osteomyelitis

3. Intracranial

4. Descending infections

5. Focal infections

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