SURGICAL ANATOMY :THE LATERAL NASAL WALL

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BASAL LAMELLA (BL)

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Uncinate Process

2 processes         Maxillary process         Inferior process

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Ethmoidal bulla

The uncinate process develops reciprocally with the ethmoidal bulla

Torus lateralis Ethmoidal bulla

Semilunar Hiatus: 2-dimensional curved groove between the uncinate process and the ethmoidal bulla

Ethmoidal Infundibulum anterior border : lacrimal bone posterior border : anterior surface of the ethmoidal bulla superior border : frontal recess medial border : entire extent of the uncinate process lateral border : lamina papyracea & frontal process of the maxilla

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A: lacrimal bone P: anterior surface of the ethmoidal bulla S: frontal recess M: uncinate process L: lamina papyracea & frontal process of maxilla

Lateral Sinus When the posterior wall of the bulla ethmoidalis is not in contact with the basal lamella of the middle turbinate, the suprabullar recess (a space superior to the bulla ethmoidalis) and retrobullar recess (a space behind the bulla ethmoidalis) form lateral sinus (=sinus lateralis of Grünwald) Borders A: roof and posterior wall of the ethmoidal bulla P: basal lamella of the middle turbinate S: roof of the ethmoid M: middle turbinate L: lamina papyracea

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A:roof and posterior wall of the ethmoidal bullaP:basal lamella of the middle turbinateS:roof of the ethmoidM:middle turbinateL:lamina papyracea

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Frontal Recess (Frontal Infundibulum): Funnel-shaped narrowing towards the frontal ostium Borders: A: agger nasi P: ethmoidal bulla & 3rd lamella S: ethmoid roof M: middle turbinate L: lamina papyracea

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A: agger nasi P: ethmoidal bulla & 3rd lamella S: ethmoid roof M: middle turbinate L: lamina papyracea

Fontanelle;Pars membrana;Membranous meatus Bony defect between the uncinate process and the inferior turbinate

Anterior

Posterior

Fontanelle & Br of sphenopalatine nerve and artery

Nasolacrimal duct; Hasner valve

5-18mm

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Anterior Ethmoid Cell (4-10): frontal recess cell infundibular cell bullar cell conchal cell extramuralncell (i.e. supradrbital cell, agger nasi cell, Haller cell)

Posterior Ethmoid Cell (1-5): intramural post ethm cell extramural post ethm cell (i.e. Onodi cell)

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Sphenoidal Otium: Position

13±3 mm above the floor of sphenoid sinus 10±4 mm below from roof of ethmoid 5±2 mm lateral to the nasal septum 7 cm posteriorly from the nostril margin at 34±4 degree angle to the floor of nasal cavity

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13±3 mm above the floor of sphenoid sinus 10±4 mm below from roof of ethmoid 5±2 mm lateral to the nasal septum 7 cm posteriorly from the nostril margin at 34±4 degree angle to the floor of nasal cavity

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Prominences or Bulges from above downwards

Prominence of the optic canal Prominence of the internal carotid artery Prominence of the maxillary nerve Prominence of the nerve of pterygoid canal ( vidian nerve)

Bulges within the Sphenoid Sinus in Saggital Section

(20%-43%;dehi 6%)

(65%-98%;dehi 25%)

(14%-29%)

(29%-48%;dehi 10%)

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