OTOLARYNGOLOGY

DEPARTMENT OF OTORHINOLARYNGOLOGY
OF LIAONING MEDICAL COLLEGE

CHEN DONG
Good morning
everybody
Rhinology
Anatomy of Nose
•External nose
•Nasal cavity
•paranasal sinuses
 The external nose
• The external nose is triangular-shaped
projection in the center of the face, consists
of osteocartilaginous framework covered by
muscles and skin.
 The external nose
Landmark
Root of nose

Nasal dorsum
Nasal bridge

Nasolabial fold

Alae nasi
Anterior naris
(nostril)

Nasal apex columella

The external nose
Framework(cartilaginous)
The external nose
Framework(bony)

frontal processes of
the maxilla.

Nasal bone

pyriform
aperture
BONE AND CARTILAGE OF NOSE
Nasal bone
fracture
Nasal bone fractures
are prevalent in sport,
particularly in
collision and contact
sports.
 DANGER TRIANGLE
OF THE FACE

Due to the special

nature of the blood
supply to the human
nose and surrounding
area, it is possible for
retrograde infections from the nasal area to
spread to the brain. For this reason, the area from
the corners of the mouth to the region between
the eyes, including the nose and maxilla, is known
to doctors as the danger triangle of the face.
 Vein of external nose

Cavernous
sinus
Superior &
inferior
ophthalmic v.

Facial v.
cavernous sinus
 Nasal cavity
• Nasal vestibule
Nasal vestibule is the anterior
and inferior part of nasal cavity. It
is lined by skin and contains
sebaceous glands,hair follicles
and hair(vibrissae) easy to
infection.
• Nasal cavity
proper
Furuncle of nasal
vestibule
 Nasal cavity
proper
• The roof .
Anterior sloping part
of the roof is formed
by nasal bones; Posterior sloping part
by the body of sphenoid bone;and the
middle horizontal part, by the
cribriform plate of ethmoid.
 Nasal cavity
proper
• The floor .
The floor of the nose
is formed by the palatal
process of the maxilla and
the horizontal process of the
palate bones.
 Nasal cavity
proper
• Medial wall.
Nasal septum.

vomer
STRCTURE OF NASAL SEPTUM
 Septum deviation

Result in－
• Nasal obstruction
• Nasal bleeding
• Headache
• Anosmia
• Sinusitis
• External deformity
Nasal cavity
proper
• Laterior wall.

The lateral wall is marked

by three scroll-like bone
projections called turbinates
or conchae.Below and
lateral to each turbinate is
the corresponding meatus.
Laterior wall of nasal cavity
 Nasal cavity
proper
Laterior wall.
Nasolacrimal duct opens in the anterior
part of inferior meatus.
The anterior group of sinuses
(frontal,marxillary and anterior ethmoidal
sinuses) open to the infundibulum in
middle meatus.
Posterior ethmoidal sinuses open into
superior meatus.
The openning of sphenoid sinus situate
is phenoethmoidal recess lies above the
superior turbinate.
 Posterior naris (choanae)

Nasal septum

Inferior turbinate
Inferior turbinate
middle turbinate
rhinosinusitis
 Ostiomeatal complex
The ostiomeatal complex is the
sinus "hot spot," one of the most
important anatomical regions with
regard to sinus health and disease.
That comprises maxillary sinus
ostia,anterior ethmoid cells and
their ostia,ethmoid infundibulum,
hiatus semilunaris, and middle
meatus.
 Nasal cavities: Microanatomy

Mucosal lining
• Respiratory epithelium
– columnar
– goblet cells
– mucus blanket ciliated pseudostratified
– cilia columnar epithelium

• Olfactory epithelium
– Small area near roof
 Nerve innervation of the nose
• Olfactory nerves
(cranial nerve I)
• Trigeminal nerve
(cranial nerve V)
• Parasympathetics
• Sympathetics
Blood supply of nasal cavity

anterior posterior
ethmoidal a. ethmoidal a.

sphenopalatine a.

iternal maxillary a.

great
palatine a.
Little plexus
 paranasal sinuses
The sinuses are air-filled
bony cavities located in the
face and skull adjacent to
the nose.
 paranasal sinuses
• Maxillary sinus
• Ethmoid sinus
• Frontal sinus
• Sphenoid sinus
 Maxillary sinus
The maxillary sinus is the
largest one, present in the
maxilla bone one either
side of nose and below the
eyes. The sinus drains into the
nasal cavity through its ostium
that is situated in the middle
meatus.
maxillary bone
maxillary bone
 Ethmoid sinus
This sinus comprises a group
of air cells, which form one of
the most complex structures in
the body. Hence the sinus is
rightly named the ethmoid
‘labyrinth’.
 ethmoid bone
 Frontal sinus
The frontal sinuses are
situated beneath the bone
of the forehead and just in
front of the bone overlying
the brain. And drains
through the frontal recess
to the middle meatus.
 Sphenoid sinus
The sphenoid sinuses are deep within the
skull behind the ethmoid sinuses. The sinus
opens in the upper part of anterior wall and
drains into the sphenoethmoidal recess.
Sphenoid bone
sphenoid
sphenoid