Recomendados
Más contenido relacionado
La actualidad más candente
La actualidad más candente (20)
Destacado
Destacado (17)
Similar a Paranasal sinus-2002-01-slides
Similar a Paranasal sinus-2002-01-slides (20)
Más de Bhishm Dubey
Último
Último (20)
Paranasal sinus-2002-01-slides
- 1. Paranasal Sinuses: Anatomy and Function Glen T. Porter, MD Francis B. Quinn, MD UTMB Department of Otolaryngology Galveston, TX January 2002 1
- 3. Sinus Anatomy Overview 7 bones 4 paired sinuses 4 turbinates 3 meati Drainage system Nervous supply Vascular supply Related structures 3
- 4. Embryology Maxilloturbinal Ethmoturbinal Middle turbinate Superior turbinate Supreme turbinate Agger nasi Uncinate process Ethmoid infundibulum Sinuses 4 Maxillary Ethmoid
- 7. Bony Structure Ethmoid Maxilla Palatine Lacrimal Pterygoid plate of Sphenoid Nasal Inferior Turbinate 7
- 8. Arterial Supply External Carotid Maxillary A. Sphenopalatine Internal Carotid Ophthalmic A. Ant. Ethmoid Post. Ethmoid Supraorbital Supratrochlear 8
- 12. Ethmoid Sinus Development Present at birth ! Anterior/Posterior ! Variability ! Structure Volume/shape ! Roof ! Lateral wall ! 12
- 13. Ethmoid Roof •Anterior 2/3 •Posterior 1/3 Keros I Keros II Keros III 13
- 14. Ethmoid Cells Supraorbital, Frontal Bulla, Concha Bullosa, Haller’s, Onodi Cells 14
- 15. Ethmoid Sinus—Related Structures Basal Lamella of the Middle Turbinate ! Three planes Agger nasi cell ! Childhood sinus Ethmoid Bulla ! ! Hiatus Semiluninaris/Superior Hiatus Semilunaris Suprabullar/retrobullar recesses (Sinus Lateralis) Ethmoid Infundibulum/Uncinate Process Anterior/Posterior Ethmoid Arteries Osteomeatal complex 15
- 16. Basal/Ground Lamella 16 Basal/Ground Lamella Of the Middle Turbinate
- 17. The Agger Nasi Cell 17
- 18. Ethmoid Bulla Uncinate Process Hiatus Semilunaris 18
- 22. Osteomeatal Complex 22 Middle meatus Maxillary Sinus Ostium Anterior Ethmoid Drainage
- 23. Maxillary Sinus Development Present at birth ! Biphasic growth ! Level of the floor ! Structure Volume & shape ! Walls, floor, roof ! 23
- 26. Maxillary Sinus Related Structures Fontanelles ! Natural ostium ! Haller’s Cells &Sinusitis ! Osteomeatal complex ! Accessory Ostium ! Nasolacrimal duct ! 26
- 27. Fontanelles 27
- 28. Natural Ostium -Haller’s cells Accessory Ostium 28
- 30. Frontal Sinus Development ! ! Frontal bone at birth Age 5 Structure ! ! ! Volume and shape Ostium Walls ! Anterior vs. posterior Related Structures ! 30 Frontal recess
- 31. Frontal Sinus Ostium Frontal recess Boundaries Dumbbell shape Sinus Lateralis Frontal Bulla 31
- 32. Sphenoidal Sinus Development Arise within the nasal capsule (no pouch) Age 3 begins to pneumatize Structure ! ! ! Volume/variable pneumatization Wall thickness Position within the sphenoid ! ! 32 Relation to sella turcica Sellar and postsellar relationships
- 36. Sphenoid Sinus Ostium ! ! ! Size (.5-4mm) Location (sinus floor, anterior nasal floor, anterior sinus wall, superior turbinate, cribiform plate) Bony dehiscence Related Structures ! ! ! 36 Sphenoethmoidal recess Sphenoid rostrum Onodi cell
- 37. Sphenoid Ostium Sphenoethmoid Recess Sphenoid Rostrum 37
- 39. Microscopic Anatomy Mucosa ! Cilliated columnar epithelial cells Anatomy ! Beat frequency ! Inhibitory effects of contact ! ! Noncilliated columnar cells Distribution ! Function ! ! 39 Basal cells
- 40. Microscopic Anatomy—Cont’d Goblet Cells Glycoproteins—viscosity and elasticity ! Innervation (para=thick, symp=thin) ! Basement membrane ! Submucosal glands ! 40 Distribution
- 42. Mucous Blanket Two layers Superficial layer ! Sol layer ! Function Superficial layer traps bacteria and particulate matter. ! Enzymes, antibodies, immune cells ! 42
- 43. Mucociliary Transport Directional Flow of Mucous ! Toward the choanae Ostium drainage—a stubborn beast ! Hilding, MD Contact inhibition Haller’s cells ! Surgery ! 43
- 45. 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 45
- 46. New Frontiers Sleep apnea and the sinuses ! ! Humidification contributes up to 6.9mm Hg serum pO2 Mouth breathers noted to have decreased end-tital CO2—increased serum CO2—apneas (high baseline) Nitric Oxide (NO) ! ! ! 46 NO produced primarily in sinuses Toxic to bacteria, fungi, viruses Increases cilliary motility
- 47. Case Report 39 yom with h/o sinus disease c/o headache, rhinorrhea. PMHx of “sinus surgery” years ago ROS reveals h/o two episodes of meningitis in past few years PE: right superior nasal mass. S/p FESS. Clear rhinorrhea. 47
- 48. 48
- 49. References Anon, Jack B., et al, Anatomy of the Paranasal Sinuses, Theime, New York, c1996. Bhatt, Nikhil J., Endoscopic Sinus Surgery: New Horizons, Singular Publishing Group, Inc., San Diego, c1997. Bailey, Byron J., et al, Head & Neck Surgery -- Otolaryngology, Lippincott Williams & Wilkins, Philadelphia, c2001. Lundberg, J., Weitzberg, E. Nasal Nitric Oxide in Man. Thorax 1999; 54(10):947-952. McCaffrey, Thomas V., Rhinologic Diagnosis and Treatment, Thieme, New York, c1997. Marks, Steven C. Nasal and Sinus Surgery, W.B. Saunders Co., Philadelphia, c2000. Navarro, Joao A.C., The Nasal Cavity and Paranasal Sinuses, Springer, Berlin, c2001. Watelet, J.B., Cauwenberge P. Van, Applied Anatomy and Physiology of the Nose and Paranasal Sinuses. Allergy 1999; 54, Supp 57:14-25. 49