Endoscopic View of Nasal
Cavity
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Bony Pyramid
– Nasal bone
– Frontal Process of maxilla
The osteotomy must be placed on the projecting frontal
process, rather than on the flat cronal plan on the
maxilla, to keep from entering the NLD.
Cartilaginous Vault
–
–
–
ULC
LLC
Lesser alar
The articulation between the caudal adge of the ULC
and LLC in of important, clinically the articulation is the
site of the intercartilaginous incision during rhinoplasty.
Nasal Cavities
–
–
–
–
Roof
Floor
Nasal septum
Lateral wall
Nasal Cavities (Roof)
– Ant.
Nasal bone
Nasal spine of frontal bone
– Mid.
Cribriform plate of the ethmoid bone
– Post
Anterior wall of sphenoid sinus
The cribroform plate is very thin and is penetrade by olfactory
filament carring meninges along with them. Making them
particularly vulnerable during nasal and ethmoid surgery.
Nasal Cavities (Floor)
– Maxillary bone ( palatal process)
– Palatine bone (horizontal process)
Nasal Cavities (septum)
–
–
–
–
Quadrilateral Cartilage
Prependicular Plate of ethmoid bone
Vomer
Nasal crest and ant nasal spine
Nasal Cavities (Lat Wall)
–
–
–
–
–
Nasal surface of the maxillary bone
Inf. Concha
Mid, Sup. Concha of the ethmoid bone
Pre pandicular plate of the palatine bone
Medial petrigoid plate of the sphenoid bone
Nasal Carities (Lat Wall)
– Ant. Sup. Partion.
Nasal bone
Front process of maxilla
Lacrimal bone
Eth. Labyrinth
Inferior Meatus
– No sinuses empty into the onferior meatus.
– site of the NLD drainage
Opening of the NLD is located in the ant. Sup. Portion of the meatus at
the point that the inf. Concha contacts the lat wall of nasal cavity
During irrigation of a max sinus or caldwell luc operation if bone is
removed too for anteriorly there is potential for damading the duct
resulting epiphora.
Lacrimal Sac
–
–
–
–
Length 12mm
Upper portion: Agarnasi cell
Lower portion: Aut of M.T
Mucos Lining : Columnar epithelium
Nasolacrimal Duct
– Length 18mm
– Directed downwards, backwards and alitlle laterally.
– Lacrimal Fold: Hasner’s valve
Sinus Drainage Schema
MAXILLARY
ANT ETHMOID
FRONTAL
POST ETHMOID
SPHENOID
LACRIMAL DUCTS
MIDDLE
MEATUS
SUPERIOR
MEATUS
INFERIOR
MEATUS
Middle concha is a important landmark
– Anterior ethmoid sinus lie is inferior (mid meatus)
– Posterior ethmoid sinus lie is superior (Sup. Meatus)
– Cribriform plate lies 1cm superior to the ant attachment of
concha.
– Lamina papyracea lies 1cm laterally to the ant attachment
of concha.
– Optic nerve lies 1cm sup laterally to the post end of concha.
– Sphenopalatin foramen lies post end of concha.
Orbital Complication
Spheno ethmoidal recess
Optic Nerve and I.C.A.
Optic Nerve Decompression