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An Anatomical Investigation of the Nasal Venous Vascular Bed in Thedog

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An Anatomical Investigation of the Nasal Venous Vascular Bed in Thedog J. Anat. (1989), 166, pp. 113-1 19 113 With 7 figures Printed in Great Britain An anatomical investigation of the nasal venous vascular bed in the dog MARY A. LUNG AND JAMES C. C. WANG Department of Physiology, Faculty of Medicine, University of Hong Kong, Li Shu Fan Building, Sassoon Road, Hong Kong (Accepted 18 February 1989) INTRODUCTION Early studies of the nasal mucosa provide a rather general description of the nasal vasculature - precapillary resistance vessels supply blood to subepithelial and periglandular capillary networks, superficial and periosteal plexuses of sinusoidal venous vessels drain into venules and numerous arteriovenous anastomoses allow the blood to bypass the capillary network (Dawes & Prichard, 1953; Cauna, 1982). Recently, we have discovered that the nasal mucosa has two functionally separate venous passageways: a system of high flow and high pressure draining the anterior nasal cavity via the dorsal nasal vein and a system of low flow and low pressure draining the posterior nasal cavity via the sphenopalatine vein; the high flow and high pressure of the anterior venous system is due to the presence of an arteriovenous anastomotic flow (Lung & Wang, 1987). We have confirmed, by means ofmicroscopic examination ofvascular casts ofthe nasal mucosa, that arteriovenous anastomoses are located only in the anterior nasal cavity (Wang & Lung, 1985). As the nasal mucosa blood drains ultimately into the jugular veins, neck occlusion will bring about a transient cessation ofoutflow from the entire nasal vascular bed and, as a consequence, equalisation of pressure in all venous channels if they are in free communication. However, we have found that neck occlusion does not lead to equalisation ofpressure throughout the anterior and posterior venous systems, indicating the existence ofsome anatomical structure(s) causing the separation of pressure and flow in the two systems (Lung & Wang, 1987). The aim of the present study is to re-investigate systematically the vascular arrangements and anatomical characteristics of the nasal venous vascular bed so as to elucidate the anatomical mechanism(s) responsible for functional separation of anterior and posterior venous systems. Some of the results have been presented in abstracts (Lung & Wang, 1988; Wang & Lung, 1988). MATERIALS AND METHODS Mongrel dogs with mesoticephalic type of skull (body weight 15 + 2-5 kg; n = 20), of either sex, were anaesthetised with sodium pentobarbitone (25 mg/kg) intra- venously. An infraorbital incision was made and the zygomatic bone was removed to expose the internal maxillary artery as well as its infraorbital and terminal branches. The infraorbital artery was cannulated retrogradely for injection of filling material or fixative into the nasal arterial vascular bed. The sphenopalatine vein, which accompanies the sphenopalatine artery, and the dorsal nasal vein, which lies above the nasal bone, were exposed and cannulated for the injection of filling material or fixative into the nasal venous vascular bed. The animal was then killed by an overdose of 114 MARY A. LUNG AND J. C. C. WANG sodium pentobarbitone (250 mg/kg) after intravenous injection of heparin (2000 units). Studies on vascular arrangements Injection material was introduced into the nasal vascular bed on both sides as previously described (Lung & Wang, 1987). In brief, a coloured latex solution (Powell Laboratories, OR, U.S.A.) was infused slowly into the nasal venous catheters at a pressure not higher than 50 mmHg while latex solution ofanother colour was similarly injected via the infraorbital arterial catheter at a pressure of 100 mmHg after occlusion of the internal maxillary artery with a snare. For the resin vascular casts, colourless or coloured partial polymerised methyl methacrylate mixture (ICI, Herts, U.K.) was infused instead. The animal was placed in a head-down position overnight in a cold room to allow for the setting of the vascular cast. For the latex vascular cast, the mucosa of the nasal cavity was removed and the soft tissues were air-dried. For the resin cast, the maxilla and the whole bony nasal cavity were removed from the body and underwent decalcification in Plank-Rychol solution for a week; the remaining soft tissues were macerated in 15 % potassium hydroxide solution and the cast was washed in running water until clean and then air-dried. Examination and photography of the vascular casts were carried out with the dissecting microscope (M650, Wild). Histological studies Nasal mucosa was removed from the nasal cavity anteriorly to the level of the dorsal nasal vein and posteriorly to the level of the sphenopalatine vein. The specimen was fixed in buffered 10% formalin solution, embedded in paraffin wax, serially sectioned at 10 ,tm, stained with Weigert's haematoxylin and counterstained with Van Gieson's picro-fuchsin solution for identification of elastic tissues, collagen fibres and vascular smooth muscle (Disbrey & Rack, 1970). In some dogs, buffered 10 % formalin solution, warmed to a temperature of 40 °C, was infused into the nasal vascular bed via the arterial and venous catheters for five minutes. For studies on vascular arrangements, resin was injected as described above. For histological studies, low melting point paraffin wax was liquefied by heating to the temperature of 40 °C and was then infused into the nasal vascular bed in the same manner. On solidification, the wax maintains the shape of blood vessels at the time of fixation during their subsequent histological treatment. RESULTS Anterior venous drainage Examination of the latex and resin casts of the anterior nasal cavity revealed that venous vessels (0-1-0-5 mm in diameter) draining blood from the anterior part of the septum curved dorsally and, together with the venous vessels (0- 1-05 mm in diameter) draining blood from the anterior part of the nasoturbinate and lateral wall, formed a venous network lateral to the nasal bone. Two to three collecting veins (0 5-l mm in diameter) arose from the venous network and they joined a few venous vessels (0'5-1 5 mm in diameter) which drained blood from the pear-shaped anterior maxilloturbinate to form the dorsal nasal vein near the nasomaxillary suture. The dorsal nasal vein emerged from the piriform aperture and curved posteriorly to travel along the external lateral surface of the maxilla. The left and right dorsal nasal veins (2-3 mm in diameter; 2-2 5 cm in length) were connected by several anastomotic vessels (0 5-l mm in diameter) forming a venous network above the nasal bone. The Nasal venous system in dogs 115 Fig. 1. Diagram illustrating macroscopic arrangements of the anterior and posterior venous systems. (1) Orbital plexus; (2) ophthalmic vein; (3) facial vein; (4) external maxillary vein; (5) external jugular vein; (6) internal maxillary vein; (7) deep facial vein (reflex vein); (8) sphenopalatine vein; (9) medial collecting vein; (10) septal collecting vein; (11) lateral collecting vein; (12) dorsal nasal vein; (13) ethmoturbinates; (14) septum; (15) maxilloturbinate; (16) nasoturbinate; (17) anastomotic veins of the left and right dorsal nasal veins. dorsal nasal vein later gave rise to the angular and facial veins. The macroscopic arrangements of the anterior venous system are illustrated in Figure 1. Histological examination of the mucosa showed that the wall thickness of the anterior veins increased towards the anterior end of the nasal cavity. The tunica media of the wall of the dorsal nasal vein was much thicker than that of an ordinary vein of similar size. Parietal bicuspid valves were found to occur at intervals in the anterior veins and ostial valves were also found to be present at the entries of tributaries into the collecting veins and the dorsal nasal vein (Fig. 2a-d). Posterior venous drainage Examination of the latex and resin casts of the posterior nasal cavity revealed that numerous venous vessels (0 1-0 3 mm in diameter) draining blood from the scroll- like posterior part of the maxilloturbinate joined the venous vessels (0 2-0 8 mm in diameter) from the maxillary sinus and lateral nasal gland to form a large collecting vein (35-A45 mm in diameter; 1 5-25 cm in length) which lay laterally in the posterior nasal cavity. Venous blood from the posterior part of the nasoturbinate, the septum and the ventral wall drained via a smaller collecting vein (1[5-2 5 mm in 116 MARY A. LUNG AND J. C. C. WANG diameter; 1-2 cm in length) which lay close to the septum. Venous blood from the ethmoturbinates and the posterior part of the dorsal wall drained via a third collecting vein (2 5-3 5 mm in diameter; 1-15 cm in length) which lay medially in the posterior nasal cavity. The septal and medial collecting veins joined the lateral collecting vein near the entrance of the sphenopalatine foramen. The lateral collecting vein emerged from the sphenopalatine foramen as the sphenopalatine vein (0O5-1l5 mm in diameter; 1 5-2-5 cm in length) which later gave rise to the deep facial vein (Fig. 3 a-b). The macroscopic arrangements of the posterior venous system are illustrated in Figure 1. Histological examination of the mucosa showed that the posterior collecting veins had very large lumina of irregular shape and a very thick tunica media (even up to 0O05 mm in thickness for the lateral collecting vein). In transverse sections of the collecting veins, the thickness of the muscle layer was found to vary greatly in different parts of the wall, indicating an uneven distribution of tunica media in the collecting veins. The sphenopalatine vein had a much thinner and evenly distributed tunica media, comparable to that of an ordinary vein. Parietal bicuspid valves were found to be present in both sphenopalatine and collecting veins and ostial valves were also present at the entries of tributaries into the collecting veins (Fig.
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