PARANASAL SINUSES

• These are air filled spaces present within some bones of

nasal cavities.
• Sinuses – FRONTAL , MAXILARY , SPHENOIDAL &
ETHMOIDAL
• Open – in nasal cavity through its lateral wall
• Function – make skull lighter
warm up & humidify the inspired air
add resonance to voice
• In sinusitis , the voice is altered
• Sinuses are rudimentary or absent at birth
• Enlarge rapidly at 6-7 yrs i.e. time of eruption of permanent
teeth & after puberty
 FRONTAL SINUS
• Lie in frontal bone, deep to superciliary arch
• Extends – upwards – above medial end of eyebrow
backwards – into medial part of roof of orbit.
• Opens – into middle meatus of nose at anterior end of
hiatus semilunaris through infundibulum or frontonasal
duct
• Average height, width & anteroposterior depth – 2.5cm
• Sinuses are better developed in males
• Right & left sinuses are unequal in size & rarely both
absent
 FRONTAL SINUS
• Rudimentary or absent at birth
• Well developed at 7-8 yrs of age & reach full size
after puberty
• Arterial supply : Supraorbital artery
• Venous drainage : into supraorbital & superior
ophthalmic veins
• Lymphatic drainage : to submandibular nodes
• Nerve supply : Supraorbital nerve
 MAXILLARY SINUS
• Largest of all paranasal sinuses
• First paranasal sinus to develop
• Lie in body of the maxilla
• Pyramidal in shape – base – medially toward the lateral wall of nose
apex – laterally in zygomatic process of maxilla
• Opens – middle meatus of nose in lower part of hiatus semilunaris
• In an isolated maxilla, opening / hiatus of maxillary sinus is large
• But the size of opening is reduced to 3/4mm as it is overlapped by
• A)above – uncinate process of ethmoid
descending part of lacrimal bone
B)below – inferior nasal concha
C)behind – perpendicular plate of palatine bone
• Further reduced by thick mucosa of nose
 MAXILLARY SINUS
• Measurements – height – 3.5 width – 2.5cm
anteroposterior depth – 3.5cm
• Formations
• ROOF – by floor of orbit & traversed by infraorbital nerve & artery
• FLOOR – by alveolar process of maxilla & lies 1cm below level of floor of
nose which corresponds to lower level of ala of nose
• Floor is marked by conical elevations produced by roots of upper molar
& premolar. Roots even penetrate bony floor to lie beneath mucousa
lining
• Arterial supply – facial , infraorbital & greater palatine arteries
• Venous drainage – into facial vein & pterygoid venous plexus
• Lymphatic drainage – submandibuar nodes
• Nerve supply – posterior superior alveolar branches of maxillary nerve
anterior & middle superior alveolar branches of
infraorbital nerve
 SPHENOIDAL SINUS
• Lie within the sphenoidal bone
• Right & left sinuses are separated by septum & unequal in
size
• Opens – into sphenoethmoidal recess of corresponding half
of nasal cavity
• Relations – superiorly – optic chiasma & hypophysis cerebri
laterally – ICA & cavernous sinus
• Arterial supply – posterior ethmoidal artery & ICA
• Venous drainage - into pterygoid venous plexus &
cavernous sinus
• Lymphatic drainage – Retropharyngeal nodes
• Nerve supply – posterior ethmoidal nerve
orbital branches of pterygopalatine
 ETHMOIDAL SINUS
• Numerous small inter-communicating spaces
• Lie within the labyrinth of ethmoid bone
• Completed by – above – by orbital plate of frontal
bone
behind – sphenoidal conchae &
orbital process of palatine bone
anteriorly – by lacrimal bone
• Sinuses are divided into anterior, middle &
posterior
• ANTERIOR ETHMOIDA L SINUS
Made of 1-11 air cells
Opens – into anterior part of hiatus semilunaris of nose
Supplied by anterior ethmoidal nerve & vessels
Lymphatic drainage – submandibular nodes

• MIDDLE ETHMOIDAL SINUS

Consists of 1-7 air cells
Opens – into middle meatus of nose
Supplied by anterior ethmoidal nerve & vessels & orbital branches of
pterygopalatine ganglion
Lymphatic drainage – submandibular nodes

• POSTERIOR ETHMOIDAL SINUS

Consists of 1-7 air cells
Opens – into superior meatus of nose
Supplied by posterior ethmoidal nerve & vessels & orbital branches of
pterygopalatine ganglion