Post on 17-Dec-2015
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Kristina Fatima Louise P. GarciaGroup 5A1
Develops as a diverticula of the lateral nasal wall
Extends to the maxilla, ethmoid, frontal and sphenoid bones
Reach maximum size at puberty and contribute to the definitive shape of the face
The maxillary sinus is the only sinus The maxillary sinus is the only sinus routinely present at birthroutinely present at birth
Conchae, Meatus and Septum sphenopalatine branch of the internal maxillary artery
Ethmoidal and Frontal Sinuses and Roof of the Nose anterior and posterior ethmoidal branches of the ophthalmic artery
Blood Supply:Blood Supply: Paranasal Paranasal SinusesSinuses
Maxillary Sinus a branch of superior labial artery; infraorbital and alveolar branches of the internal maxillary artery
Sphenoid Sinus pharyngeal branch of the internal maxillary artery
Blood Supply:Blood Supply: Paranasal Paranasal SinusesSinuses
Nerve SupplyNerve Supply
1. infraorbital nerve 2. posterior superior
alveolar nerve 3. pterygopalatine
ganglion (parasympathetic)
4. greater palatine nerve 5. lesser palatine nerve 6. cut nasopalatine
nerve 7. nerve of the
pharyngeal canal
• All of the nerves are sensory branches of V2. • The pterygopalatine ganglion is suspended from
V2 by two sensory roots. Since the ganglion is parasympathetic, there are preganglionic neurons feeding into it from the facial nerve (greater petrosal branch) that synapse at this point then continue onward as postganglionic neurons.
• Their destination is the lacrimal nerve and reach there by rejoining the maxillary nerve through a sensory root, hopping onto the zygomatic nerve (V2), running up the lateral side of the orbit to jump onto the lacrimal nerve (V1) and then to the lacrimal gland to produce tears.
Olfaction Chemical Theory Undulation Theory Sinuses have no obvious physiologic
function. Airway Resistance
Variations in nasal resistance are due primarily to changes in the erectile tissues of the turbinates
Air Conditioning Inspired air is warmed (or cooled) to near
body temperature and its relative humidity is brought to near 100 percent.
Air Purification Hairs or vibrissae Solubility of gases
PhysiologyPhysiology
Mucociliary Function Transport of foreign particles is carried out
via action of cilia moving the mucous blanket with its entrapped particles
Pulmonary Correlations
Speech Modification
PhysiologyPhysiology
Clinical Picture Signs and symptoms
depend upon the sinuses involvedMaxillary = maxillary sinus and the adjacent midface and temple
Ethmoid = over bridge of the nose and medial canthus of the eye
Frontal = over the anterior wall and floor of the frontal sinus with pain radiating to the medial canthus
Sphenoid = non-specific, marked by dull, aching pressure located at the center of the skull and radiating to the occiput
Acute SinusitisAcute Sinusitis
Diagnostics Rhinoscopy or nasal endoscopy Sinus radiograph
Acute SinusitisAcute Sinusitis
Acute SinusitisAcute Sinusitis
CT Scan MRI
Management Conservative: antibiotics, analgesics and
decongestants Surgical: maxillary sinus puncture following
decongestion and topical anesthesia of the nasal mucosa Sharp puncture, Blunt puncture, Beck
puncture
Acute Sinusitis
Chronic inflammatory, allergic, traumatic, neoplastic
Impaired ventilation of the ostiomeatal unit due to stenosis and obstruction Poor drainage > swollen mucosa esp at the
narrow anatomical passages > recurrent bouts of inflammation > persistent, chronic sinusitis
DiagnosisDiagnosis Rhinoscopy, Endoscopy
Turbinate hyperplasia, pneumatized middle turbinate, concha bullosa, change in appearance of ostiomeatal unit, change in the nasal septum
CT Scan TreatmentTreatment
Decongestants, heat therapy, antibiotics, mucolytics
Sinus surgery – definitive treatment Endoscopic sinus surgery
Mucocele – cystlike, mucus containing sac that can form within the paranasal sinus
Pyocele – mucocele containing purulent material (superinfection)
Caused by adhesions or mass lesions that obstruct drainage from the paranasal sinus system Frontal > Ethmoid > Maxillary > Sphenoid
Obstruction > INC pressure on sinus wall > thinning of bone > erosion of mass
Clinical PictureClinical Picture Frontal: isolated, tense swelling over the ant. wall of the
frontal sinus, inferolateral displacement of orbital contents
Maxillary: swelling in the cheek area, upward displacement of orbital contents
Sphenoid: non-specific DiagnosticsDiagnostics
Prior surgical history, clinical appearance CT, MRI
TreatmentTreatment Surgical removal
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