CLINICAL AND CROSS

SECTIONAL ANATOMY

OF PNS

ByRoshan Shah

B.Sc. MIT 2nd year3rd batch

Nose External nose Nasal cavity

Both are divided by nasal septum into right and left halves.

ANATOMY

It has, Naris Alar nasi It is made up of, Nasal bone Frontal process of

maxilla Nasal part of

frontal bone

EXTERNAL NOSE

The nasal cavity has, Floor Roof Medial wall Lateral wall

NASAL CAVITY

The lateral wall consist of, Concha Meatus

Concha has, Superior concha Middle concha Inferior concha

Meatus has, Inferior meatus Middle meatus Superior meatus Sphenoethmoidal recess

CONT…

Sinus are air space in our skull & facial bone

They are four types 1. Frontal2. Ethmoid3. Sphenoid4. Maxillary

INTRODUCTION

Shape:- Pyramidal shape Location:- between inner and outer

table frontal bone Border:- Anterior:- outer table Posterior:- inner table Floor:- thin bone separating from the orbit Medial:- bony septum

FRONTAL SINUS

It consists of three group1. Anterior group:- 2. Middle group:- 3. Posterior group

Border:- Roof:- anterior cranial fossa lateral to

cribriform plate Posterior:- sphenoid sinus Inferior:- maxillary sinus Medial:- superior and middle turbinate Lateral:- lamina papracea

ETHMOID SINUSES

Largest sinus Pyramidal shape Border:- Roof:- floor of orbit Floor:- alveolar process of maxilla & palate Medial:- between sinus & nasal cavity Anterior:- soft tissue of cheek Posterior:- pterygopalatine & infra temporal

fossae

MAXILLARY SINUS

Two sphenoid sinuses Separated by a septum Border:- Lateral:- ICA & cavernous sinus Superior:- pituitary gland & optic chiasma Inferior:- nasopharynx Posterior:- brain stem

SPHENOID SINUS

The anatomy of drainage revolves around the ostiomeatal unit.

Middle turbinate Ethmoid bulla Hiatus semilunaris Maxillary infundibulum Uncinate process

DRAINAGES OF SINUSES

CONT…

Frontal Middle meatus via infundibulum

Maxillary

Middle meatus through hiatus semilunaris

Sphenoid

Sphenoethmoidal recess

Ethmoid Anterio

r groupInfundibulum & middle meatus

Middle group

Middle meatus on or above bullae ethmoidals

Posterior group

Superior meatus

Trauma to face Inflammatory Sino nasal disease Granulomatous disease Preoperative staging of tumors Postoperative follow up Neoplastic Sino nasal disease

INDICATION

X-ray Occipito-mental occipito-frontal 15° caudal Lateral

CT-scan Coronal scan Axial Sagittal

MRI is generally used for evaluating of any complication of local sinus infection particularly suspected intracranial extension

EXAMINATION

Frontal sinusFrontal bone

AT THE LEVEL OF FRONTAL SINUS

Nasal septumLamina

papyraceaEthmoid sinusesSphenoid sinussella turcicaGreater

sphenoid wingDorsum sella

AT THE LEVEL OF ETHMOID SINUS

Nasal septumSphenoid sinusSphenoid sinus

ostiumMiddle turbinateZygomaLacrimal sacNasal boneMaxillary sinus

AT THE LEVEL OF SPHENOID SINUS

Maxillary sinusNasolacrimal

ductSphenoid sinusVomerInferior

turbinateZygomatic arch

AT THE LEVEL OF MAXILLARY SINUS

CORONAL IMAGES

SAGITTAL IMAGES

MRI IMAGE

SINUSITIS

POLYP

DNS

Thank you