Nasal cavity, paranasal sinuses for ED II.
Dr. Ágota Ádám
Concha (anatomical term) = turbinate (clinical term) Sup. & middle turbinate = ‚ethmoturbinal’ (clin.) External nose
Nasal bone; paired lateral and major cartilages + several minor alar cartilages
Rhinoplasty (‚nose job’): https://www.youtube.c om/watch?v=dyNpojnb NT4 Nasal cavity – lateral wall
1. frontal process of the maxilla 2. body of the maxilla (nasal surface) 3. lacrimal hamulus of the lacrimal bone 4. ethmoidal labyrinths 5. inferior nasal concha 6. perpendicular plate of palatine bone 7. medial lamina of the pterygoid process of the sphenoid bone Nasal cavity – roof
1. nasal bone 2. nasal part of the frontal bone 3. cribriform plate of the ethmoid bone 4. anterior and inferior surfaces of the body of the sphenoid bone Nasal cavity – floor = hard palate: 1. palatine process of maxilla 2. horizontal plate of the palatine bone Nasal septum
1. Cartilagineous part 2. Bony part: vomer, perpendicular plate of ethmoid Blood supply of the nasal cavity
Lateral wall: From ICA
Ant. ethmoidal a. Post. ethmoidal a. Sphenopalatine a. Descending palatine a.
From ECA Blood supply of the nasal septum
Kiesselbach's plexus: vascular network of the four arteries that supply the nasal septum. The arteries anastomose → From ICA common site for nosebleeds.
It lies in the anterior inferior part of the septum known Kiesselbach's area.
From ECA Innervation of the nasal cavity
from CN 5/1
from CN 5/2 Paranasal sinuses Maxillary sinus & its dental relevance
Functions: • Warming and moisturizing inhaled air • Accessory olfactory organ • Resonance of voice • Lightening of skull weight
Recesses: anterior, porterior, zygomatic, ethmoidal and alveolar (a, interdental sinuses & b, interradicular sinuses) a b
Fully developed by age of 12 years. Capacity: 15 ml Maxillary sinus & its dental relevance
Normal maxillary sinuses Acute maxillary sinusitis Maxillary sinus & its dental relevance
Maxillary sinusitis of dental origin: spread of infection from peri-apical or periodontal lesions Maxillary sinus & its dental relevance Low maxillary sinus floor Maxillary sinus & its dental relevance
After implantation Dental implant placement in the posterior maxilla may be complicated by implant migration into the maxillary sinus.
Most at risk: 3rd molar & 2nd premolar
3 months after 6 months after (removal attempt) Maxillary sinus & its dental relevance
Root canal treatment close to the sinus lining may open a ‚sinus communication’
Most „dangerous” teeth: Mesiobuccal root of 1st molar & palatal root of 2nd premolar
Oro-antral communication Frontal sinus
Infundibulum ethmoidale
From age of 3. Fully developed by age of 18-20 years Ethmoid air cells
In the ethmoidal labyrinth. Numbers vary (apprx. 18). Most anterior group: ‚agger nasi cells’ (key point in frontal sinus surgery) Ethmoid bulla: protrusion containing the ant. ethmoidal cells Sphenoid sinus
Within the body of the sphenoid; usually divided by a septum into 2 irregular cavities. Opening: sphenoethmoidal recess (post. to the sup. nasal concha)
endoscopic trans-sphenoidal surgical approach to the hypophysis
From age of 8. Fully developed by age of 12-15 years