By Robin Youngs, Kathryn Evans, Michael Watson
This booklet goals to supply the trainee general practitioner with the anatomical wisdom required to accomplish secure endoscopic sinus surgical procedure. It presents a stepwise method of sinus anatomy and is loosely dependent round the curriculum of the college of Cambridge Endoscopic Sinus Anatomy path. prime quality photographs derived from cadaver dissection, with CT test radiological correlates and endoscopic pictures, are used all through. This booklet is perfect for trainees at registrar or resident point to be used within the working theatre and as a dissection consultant for cadaver endoscopic sinus surgical procedure classes. The authors, with lots of event in working such classes, upload important scientific and surgical details as suitable.
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Extra resources for The Paranasal Sinuses
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Also, a distinct ‘maxillary line’ can be seen anterior to the turbinate, marking the junction between the thick bone of the frontal process of the maxilla and the thin uncinate process of the ethmoid. In its superior part, the maxillary line also lies over the lacrimal bone and lacrimal sac – a landmark used in endonasal lacrimal surgery. The middle turbinate is subject to variations in size and shape. The turbinate is frequently pneumatised – the so-called ‘concha bullosa’. This pneumatisation 35 THE PARANASAL SINUSES 1 2 3 4 5 Coronal CT scan through the anterior nasal cavity.
Laterally, the choanae are bordered by the perpendicular plate of the palatine bone. With the posterior edge of the vomer being in the midline in over 90% of cases, choanal asymmetry is uncommon. The posterior choanae lead into the cavity of the nasopharynx. In the nasopharynx, the most prominent structure is the pharyngeal opening of the Eustachian tube. Just behind the tubal opening lies the Eustachian cushion or tubal eminence. Between the tubal eminence and posterior nasopharyngeal wall lies a fossa (of Rosenmüller) of varying dimension – this is an important site clinically in the pathogenesis of nasopharyngeal carcinoma.
The basal lamella of the middle turbinate forms its posterior boundary. Anteriorly, it is separated from the frontal recess only when the bulla lamella reaches the skull base. Otherwise, the suprabullar recess opens into the frontal recess. The suprabullar and retrobullar recesses can be approached from medially and inferiorly through the hiatus semilunaris superior. The suprabullar recess may join 51 THE PARANASAL SINUSES with the retrobullar recess when the posterior wall of the ethmoid bulla is not in contact with the basal lamella of the middle turbinate.