Dear Subscribers! This Issue of Our Magazine Is Devoted to Cooperation of Our Editorial Board with Ukrainian Medical Scientists

Deutscher Wissenschaftsherold • German Science Herald, N 4/2016

Dear subscribers! This issue of our magazine is devoted to cooperation of our editorial board with Ukrainian medical scientists. We present you the results of their researches.

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Boichuk O.M. Higher State Educational Institution of Ukraine “Bukovinian State Medical University”, M.H. Turkevych Department of Human Anatomy, Chernivtsi, Ukraine, [email protected] Kryvetska I.I. Higher State Educational Institution of Ukraine “Bukovinian State Medical University”, S.M. Savenko Department of Neurology, Psychiatry and Medical Psychology Chernivtsi, Ukraine Bambuliak A.V. Higher State Educational Institution of Ukraine “Bukovinian State Medical University”, Department of Surgical and Pediatric Dentistry, Chernivtsi, Ukraine, [email protected] Sapunkov O.D. Higher State Educational Institution of Ukraine “Bukovinian State Medical University”, Department of Pediatric Surgery and Otolaryngology, Chernivtsi, Ukraine

STRUCTURAL COMPONENTS OF AUTONOMIC INNERVATION OF MUCOSA OF NASAL CAVITY AND PARANASAL SINUSES

Abstract. Autonomic innervation of mucosa of the nasal cavity and paranasal sinuses has been studied using complex morphological methods. It was determined that autonomic innervation of the nasal cavity and paranasal sinuses mostly occurs due to the branches of the pterygopalatine ganglion Keywords: nasal cavity, paranasal sinuses, innervation, pterygopalatine ganglion, mucosa, anatomy.

Introduction. Mucosa of nasal cavity is peripheral element of olfactory analyzer functionally large receptor surface with a very consists of highly specialized epithelium of the complex and various reflex connections. It is upper nasal passage, short dendrites, which equipped with lots of blood and lymphatic ends with receptors, and axons form olfactory vessels, which are surrounded with numerous filaments that enter the olfactory bulb where nerve endings. The main factor in the regulation contact with other neurons [5]. of trophic of the nasal cavity and paranasal Objective: to study ways of autonomic sinuses is their autonomic innervation, innervation of mucosa of nasal cavity and consisted of trophic (sympathetic) and secretory paranasal sinuses. (parasympathetic) fibers [1, 2]. Materials and methods. 32 samples of nasal The autonomic innervation of the nasal cavity area of people of all ages were studied by is closely linked with the olfactory. Olfactory complex of the following morphological analyzer is one of the phylogenetically oldest methods: histological method, preparation, body systems and is the leading analyzer for radiological and morphometric methods. The most mammals. Sense of smell in the human is samples were obtained from corpses of people not as highly developed as in certain animals, who died from causes unrelated to the ENT but the cerebral mechanisms of smell are closely disorders. The study was performed in strict linked to fundamental mechanisms of formation accordance with the Helsinki Declaration of the of needs, motivations and emotions [3, 4]. The World Medical Association "Ethical Principles for

Medical Research Involving Human Subjects" the pterygopalatine fossa. (1964-2000). The study of the nasal area was Segmental centers of sympathetic carried out in Chernivtsi regional forensic innervation of the mucosa of the nasal cavity medical bureau and M.G. Turkevych department and paranasal sinuses lay in the of human anatomy of SHEI of Ukraine intermediolateral nucleus of the lateral horns of "Bukovinian State Medical University". The side the gray matter of the upper thoracic spinal cord walls of the nose and formations adjacent to segments. The axons of the nucleus cells go out them were dissected consistently with surgical of the spinal cord as a part of the anterior roots. instruments, starting from their posterior. The Departing from the latter, they form white sphenopalatine foramen and pterygopalatine connecting branches which approach the ganglion were determined, the nerve branches sympathetic trunk, namely the lower cervical were dissected, and their path and the one of ganglion or the stellate ganglion, the lower branches that branching from them were cervical and first thoracic ganglions are often traced. Further back nasal branches of connected forming the stellate ganglion. The pterygopalatine ganglion were studied. The preganglionic fibers rise by the sympathetic levels of their discharge and syntopy were trunk and reach the upper cervical sympathetic revealed. Similar studies were carried out on ganglion and break up there. The postganglionic frontal and horizontal autopsy of samples. From fibers that starting from the upper cervical some samples the mucosa was dissected for ganglion – the internal carotid nerve, form the histological study. internal carotid plexus around the internal Results and discussion. The interest in the carotid artery, from which at the torn hole the detailed study of the autonomic innervation of branch – the deep petrosal nerve take the start. the mucosa of the nasal cavity and paranasal It should be emphasized that the sinuses increased since the appearance of vidian greater petrosal nerve fibers are preganglionic neurectomy. It is known that the source of and the deep petrosal nerve fibers are parasympathetic innervation of the mucosa of postganglionic. From this it follows that the the nasal cavity and paranasal sinuses is a nerve of pterygoid canal – which is known in the superior salivary nucleus, which belongs to the literature as Vidian nerve, is composed of intermediate nerve, inherent in the reticular parasympathetic preganglionic and formation of pons [6]. postganglionic sympathetic nerve fibers. Intermediate nerve is closely linked in its The direct nerve trunks involved in course with facial nerve, they go around the autonomic innervation of these areas are the back edge of the pons, between the pedunculi branches of the pterygopalatine ganglion. cerebellares medii and lower oliva cerebelli. The postganglionic sympathetic fibers are the Then it enters the inner ear and deeply in it part of the nerve trunks. Some of the sensitive enters the channel of the facial nerve deep in fibers of the second branch of the trigeminal the temporal bone. In the place where the nerve, which are also the part of the branches of channel changes its direction from the front side the pterygopalatine ganglion, also go through to the back some of parasympathetic fibers – the the pterygopalatine ganglion. The mucosa of the greater petrosal nerve leaves the channel and nasal cavity and paranasal sinuses receives falls in the same sulcus on the front surface of sympathetic innervation, in contrast to the pyramid of the temporal bone, goes to the parasympathetic one, not only from the torn hole and leaves the cranial cavity through pterygopalatine node, but also from the internal it, going into the pterygoid canal. In this place carotid plexus, the fibers of which reach the the sympathetic nerve - the deep petrosal nerve nasal cavity directly with end branches of the – approaches to the greater petrosal nerve, sphenopalatine, ophthalmic and ethmoidal forming a trunk – the nerve of pterygoid canal. arteries. The latter, entering the channel and passing it There are also indications that some of the reaches the pterygopalatine ganglion, located in sympathetic fibers, namely the vasoconstrictors

4 Deutscher Wissenschaftsherold • German Science Herald, N 4/2016 and secretory leaders, pass through the of the nasal cavity, features of the innervation of trigeminal ganglion and join its sensitive fibers the paranasal sinuses, their syntopy with the going to the periphery and penetrating adjacent structures are not studied enough. everywhere the latter go. Some studies are devoted to this question, but The branches of the pterygopalatine ganglion they are limited, not general and, of course, can form the upper, the medial and lower groups. serve as a basis for the development of surgery The upper branches or the orbitales of the of autonomic nerves for the nasal cavity. pterygopalatine ganglion in most cases are Prospects for further research. It is planned connected with the ciliary ganglion and its to study blood supply of nasal area and branches, as well as participate in paranasal sinuses in different periods of human parasympathetic innervation of the lacrimal ontogenesis. gland. The group of the lower branches is References: formed from the large and small palatine nerves, 1. Клыпа Н.Д. Вегетативная иннервация which come directly from the pterygopalatine ротовой и носовой полостей / Н.Д. Клыпа / ganglion and enter into the pterygopalatine «Студенческий научный форум»: V canal, where go to the palatine foramens and Международная студенческая электронная innervate the blood vessels and glands of the научная конференция (15 февраля – 31 mucosa of the hard and soft palate at the exit of марта 2013 года). – the foramens. The branches of front of these http://www.scienceforum.ru/2013/. nerves – the greater palatine nerve passes the 2. Боєнко Д.С. Рецепторний апарат medial wall of the channel near the back end of слизової оболонки клиноподібної пазухи при the inferior turbinate, enter the mucosa and сфеноїдиті / Д.С. Боєнко, В.Г. Шлопов // branch there, and in the mucosa of the middle Ринологія. – 2012 – № 1. – С. 9-12. and lower nasal passages. They are also involved 3. Doty R.L. Olfaction / R.L. Doty // Annual in autonomic innervation of the mucosa of the Review of Psychology. – 2000. – Vol. 52. – P. 423- maxillary sinus. 452. The medial group consists of the pharynx and 4. Rolls E.T. Different representations of upper posterior nasal branches. They depart pleasant and unpleasant odours in the human from the pterygopalatine ganglion, pass through brain / E.T. Rolls, M.L. Kringelbach, I.E. Araujo // the sphenopalatine foramen and enter the nasal Eur. J. Neurosci. – 2003. – Vol. 18, № 3. – Р. 695- cavity, passing close to the bottom wall of the 703. sphenoid sinus. They end in the mucosa of the 5. Шевчук Ю.В. Клініко-експериментальне lateral surface of the throat, and sometimes can дослідження периферійної ланки нюхового be traced to the pharyngeal opening of auditory аналізатора / Ю.В. Шевчук // Науковий tube. Most of these branches go independently вісник Ужгородського університету, серія from the pterygopalatine ganglion in the «Медицина». – 2008. – Вип. 33. – С. 72-74. number of 3-5, and in some cases go from the 6. Анатомія людини. У трьох томах. Том total trunk with the back upper nasal branches. третій / [Головацький А.С., Черкасов В.Г., Sometimes the pharyngeal branches go directly Сапін М.Р., Парахін А.І.]; За ред. В.Г. from the pterygoid canal nerve. Черкасова та А.С. Головацького. – Вінниця: Conclusions: The course, distribution, plant Нова Книга, 2009. – 376 с.: Іл. of the autonomic nerve branches in the mucosa