Ethmoid sinus

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Ethmoid sinus
Paranasal Sinuses ant.jpg
Frontal view of paranasal sinuses
Gray859.png
Coronal section of nasal cavities.
Details
Nerve posterior ethmoidal nerve
Identifiers
Latin cellulae ethmoidales,
labyrinthi ethmoidales
MeSH D005005
TA98 A06.1.03.005
TA2 3180
FMA 84115
Anatomical terms of bone

The ethmoid sinuses or ethmoid air cells of the ethmoid bone are one of the four paired paranasal sinuses. [1] Unlike the other three pairs of paranasal sinuses which consist of one or two large cavities, the ethmoidal sinuses entail a number of small air-filled cavities ("air cells"). [2] The cells are located within the lateral mass (labyrinth) of each ethmoid bone and are variable in both size and number. [1] The cells are grouped into anterior, middle, and posterior groups; the groups differ in their drainage modalities, [2] though all ultimately drain into either the superior or the middle nasal meatus [3] of the lateral wall of the nasal cavity.

Contents

Structure

The ethmoid air cells consist of numerous thin-walled cavities in the ethmoidal labyrinth [4] that represent invaginations of the mucous membrane of the nasal wall into the ethmoid bone. [3] They are situated between the superior parts of the nasal cavities and the orbits, and are separated from these cavities by thin bony lamellae. [4]

There are 5-15 air cells in either ethmoid bone in the adult, with a combined volume of 2-3mL. [5]

Development

The ethmoidal cells (sinuses) and maxillary sinuses are present at birth. [6] At birth, 3-4 air cells are present, with the number increasing to 5-15 by adulthood. [5]

Drainage

Lamellae

The ethmoidal labyrinth is divided by multiple obliquely oriented, parallel lamellae. The first lamellae is equivalent to the uncinate process of ethmoid bone, the second corresponds the ethmoid bulla, and the third is the basal lamella, and the fourth is equivalent to the superior nasal concha. [5]

The anterior and posterior ethmoid cells are separated by the basal lamella [7] [5] (also known as the ground lamella). [5] It is one of the bony divisions of the ethmoid bone and is mostly contained inside the ethmoid labyrinth. The basal lamella is continuous medially with the bony middle nasal concha. [7] Anteriorly, it vertically inserts into the ethmoid crest; the middle part attaches obliquely into the orbital lamina of ethmoid bone (lamina papyricea) while the posterior part attaches into the orbital lamina horizontally. [5]

Innervation

The ethmoidal air cells receive sensory innervation from the anterior and the posterior ethmoidal nerve (which are ultimately derived from the ophthalmic branch (CN V1) of the trigeminal nerve (CN V)), [3] and the orbital branches of the pterygopalatine ganglion, which carry the postganglionic parasympathetic nerve fibers for mucous secretion from the facial nerve.[ clarification needed ][ citation needed ]

Haller cells

Haller cells are air cells situated beneath the ethmoid bulla along the roof of the maxillary sinus and the most inferior portion of the lamina papyracea, including air cells located within the ethmoid infundibulum. [8] These may arise from the anterior or posterior ethmoidal sinuses.[ citation needed ]

Onodi cells

Also known as a sphenoethmoidal air cell, an Onodi cell is a posterior ethmoidal air cell that lies superolateral to the sphenoid sinus, often extending into the anterior clinoid process. [9] Onodi cells are clinically significant because they lie in close proximity to the optic nerve and internal carotid artery, so surgeons should be aware of their existence when performing surgery on the sphenoid sinus so as not to damage these important structures.

A central Onodi air cell is a variation in which a posterior ethmoid cell lies superior to the sphenoid sinus in a midline position with at least one optic canal bulge. [10]

Clinical significance

Acute ethmoiditis in childhood and ethmoidal carcinoma may spread superiorly causing meningitis and cerebrospinal fluid leakage or it may spread laterally into the orbit causing proptosis and diplopia. [11]

Additional images

Related Research Articles

<span class="mw-page-title-main">Paranasal sinuses</span> Air-filled spaces surrounding the nasal cavity

Paranasal sinuses are a group of four paired air-filled spaces that surround the nasal cavity. The maxillary sinuses are located under the eyes; the frontal sinuses are above the eyes; the ethmoidal sinuses are between the eyes and the sphenoidal sinuses are behind the eyes. The sinuses are named for the facial bones and sphenoid bone in which they are located. Their role is disputed and no function has been confirmed.

Articles related to anatomy include:

<span class="mw-page-title-main">Ethmoid bone</span> Bone in the skull

The ethmoid bone is an unpaired bone in the skull that separates the nasal cavity from the brain. It is located at the roof of the nose, between the two orbits. The cubical bone is lightweight due to a spongy construction. The ethmoid bone is one of the bones that make up the orbit of the eye.

<span class="mw-page-title-main">Sphenoid bone</span> Bone at the front of the skull

The sphenoid bone is an unpaired bone of the neurocranium. It is situated in the middle of the skull towards the front, in front of the basilar part of the occipital bone. The sphenoid bone is one of the seven bones that articulate to form the orbit. Its shape somewhat resembles that of a butterfly or bat with its wings extended.

<span class="mw-page-title-main">Nasal cavity</span> Large, air-filled space above and behind the nose in the middle of the face

The nasal cavity is a large, air-filled space above and behind the nose in the middle of the face. The nasal septum divides the cavity into two cavities, also known as fossae. Each cavity is the continuation of one of the two nostrils. The nasal cavity is the uppermost part of the respiratory system and provides the nasal passage for inhaled air from the nostrils to the nasopharynx and rest of the respiratory tract.

<span class="mw-page-title-main">Orbit (anatomy)</span> Cavity or socket of the skull in which the eye and its appendages are situated

In anatomy, the orbit is the cavity or socket/hole of the skull in which the eye and its appendages are situated. "Orbit" can refer to the bony socket, or it can also be used to imply the contents. In the adult human, the volume of the orbit is 30 millilitres, of which the eye occupies 6.5 ml. The orbital contents comprise the eye, the orbital and retrobulbar fascia, extraocular muscles, cranial nerves II, III, IV, V, and VI, blood vessels, fat, the lacrimal gland with its sac and duct, the eyelids, medial and lateral palpebral ligaments, cheek ligaments, the suspensory ligament, septum, ciliary ganglion and short ciliary nerves.

<span class="mw-page-title-main">Orbital part of frontal bone</span>

The orbital or horizontal part of the frontal bone consists of two thin triangular plates, the orbital plates, which form the vaults of the orbits, and are separated from one another by a median gap, the ethmoidal notch.

<span class="mw-page-title-main">Uncinate process of ethmoid bone</span>

In the ethmoid bone, a sickle shaped projection, the uncinate process, projects posteroinferiorly from the ethmoid labyrinth. Between the posterior edge of this process and the anterior surface of the ethmoid bulla, there is a two-dimensional space, resembling a crescent shape. This space continues laterally as a three-dimensional slit-like space - the ethmoidal infundibulum. This is bounded by the uncinate process, medially, the orbital lamina of ethmoid bone, laterally, and the ethmoidal bulla, posterosuperiorly. This concept is easier to understand if one imagine the infundibulum as a prism so that its medial face is the hiatus semilunaris. The "lateral face" of this infundibulum contains the ostium of the maxillary sinus, which, therefore, opens into the infundibulum.

<span class="mw-page-title-main">Sphenoid sinus</span> One of the four paired paranasal sinuses

The sphenoid sinus is a paired paranasal sinus occurring within the body of the sphenoid bone. It represents one pair of the four paired paranasal sinuses. The pair of sphenoid sinuses are separated in the middle by a septum of sphenoid sinuses. Each sphenoid sinus communicates with the nasal cavity via the opening of sphenoidal sinus. The two sphenoid sinuses vary in size and shape, and are usually asymmetrical.

<span class="mw-page-title-main">Semilunar hiatus</span>

The semilunar hiatus is a crescent-shaped/semicircular/ curved slit/groove upon the lateral wall of the nasal cavity at the middle nasal meatus just inferior to the ethmoidal bulla. It is the location of the openings for the frontal sinus, maxillary sinus, and anterior ethmoidal sinus. It is bounded inferiorly and anteriorly by the sharp concave margin of the uncinate process of the ethmoid bone, superiorly by the ethmoidal bulla, and posteriorly by the ethmoidal process of the inferior nasal concha. It leads into the ethmoidal infundibulum; it marks the medial limit of the ethmoidal infundibulum.

<span class="mw-page-title-main">Ethmoidal labyrinth</span>

The ethmoidal labyrinth or lateral mass of the ethmoid bone consists of a number of thin-walled cellular cavities, the ethmoid air cells, arranged in three groups, anterior, middle, and posterior, and interposed between two vertical plates of bone; the lateral plate forms part of the orbit, the medial plate forms part of the nasal cavity. In the disarticulated bone many of these cells are opened into, but when the bones are articulated, they are closed in at every part, except where they open into the nasal cavity.

<span class="mw-page-title-main">Anterior ethmoidal artery</span>

The anterior ethmoidal artery is a branch of the ophthalmic artery in the orbit. It exits the orbit through the anterior ethmoidal foramen alongside the anterior ethmoidal nerve. It contributes blood supply to the ethmoid sinuses, frontal sinuses, the dura mater, lateral nasal wall, and nasal septum. It issues a meningeal branch, and nasal branches.

<span class="mw-page-title-main">Superior nasal concha</span>

The superior nasal concha is a small, curved plate of bone representing a medial bony process of the labyrinth of the ethmoid bone. The superior nasal concha forms the roof of the superior nasal meatus.

<span class="mw-page-title-main">Sphenoethmoidal recess</span>

The sphenoethmoidal recess is a small triangular space of the superior nasal meatus of the nasal cavity into which the sphenoidal sinus and the posterior ethmoidal air cells open. The sphenoethmoidal recess is situated superoposterior to the superior nasal concha, between the superior nasal concha and the anterior aspect of the body of the sphenoid bone.

<span class="mw-page-title-main">Anterior cranial fossa</span>

The anterior cranial fossa is a depression in the floor of the cranial base which houses the projecting frontal lobes of the brain. It is formed by the orbital plates of the frontal, the cribriform plate of the ethmoid, and the small wings and front part of the body of the sphenoid; it is limited behind by the posterior borders of the small wings of the sphenoid and by the anterior margin of the chiasmatic groove. The lesser wings of the sphenoid separate the anterior and middle fossae.

<span class="mw-page-title-main">Perpendicular plate of palatine bone</span>

The perpendicular plate of palatine bone is the vertical part of the palatine bone, and is thin, of an oblong form, and presents two surfaces and four borders.

<span class="mw-page-title-main">Body of sphenoid bone</span>

The body of the sphenoid bone, more or less cubical in shape, is hollowed out in its interior to form two large cavities, the sphenoidal sinuses, which are separated from each other by a septum.

<span class="mw-page-title-main">Human nose</span> Feature of the human face

The human nose is the first organ of the respiratory system. It is also the principal organ in the olfactory system. The shape of the nose is determined by the nasal bones and the nasal cartilages, including the nasal septum which separates the nostrils and divides the nasal cavity into two.

<span class="mw-page-title-main">Outline of human anatomy</span> Overview of and topical guide to human anatomy

The following outline is provided as an overview of and topical guide to human anatomy:

<span class="mw-page-title-main">Nasal meatus</span> Nasal passage of the nasal cavity

In anatomy, the term nasal meatus can refer to any of the three meatuses (passages) through the skull's nasal cavity: the superior meatus, middle meatus, and inferior meatus.

References

PD-icon.svgThis article incorporates text in the public domain from page 154 of the 20th edition of Gray's Anatomy (1918)

  1. 1 2 Illustrated Anatomy of the Head and Neck, Fehrenbach and Herring, Elsevier, 2012, page 64
  2. 1 2 Morton, David A. (2019). The Big Picture: Gross Anatomy. K. Bo Foreman, Kurt H. Albertine (2nd ed.). New York. p. 246. ISBN   978-1-259-86264-9. OCLC   1044772257.{{cite book}}: CS1 maint: location missing publisher (link)
  3. 1 2 3 4 5 6 7 Moore, Keith L.; Dalley, Arthur F.; Agur, Anne M. R. (2017). Essential Clinical Anatomy (6th ed.). Lippincott Williams & Wilkins. p. 968. ISBN   978-1496347213.
  4. 1 2 3 4 Otorhinolaryngology, Head and Neck Surgery, Anniko, Springer, 2010, page 188
  5. 1 2 3 4 5 6 7 8 9 Cappello, Zachary J.; Minutello, Katrina; Dublin, Arthur B. (2023), "Anatomy, Head and Neck, Nose Paranasal Sinuses", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID   29763001 , retrieved 2023-07-04
  6. Moore, K.L Et al(2014). Clinically Oriented Anatomy. Baltimore: Page960
  7. 1 2 Hechl, Peter S.; Setliff, Reuben C.; Tschabitscher, Manfred (1997). "The ethmoid bone and middle turbinate". Endoscopic Anatomy of the Paranasal Sinuses. Springer Vienna. pp. 9–28. doi:10.1007/978-3-7091-6536-2_2. ISBN   978-3-7091-7345-9.
  8. Raina, A; Guledgud, M V; Patil, K (May 2012). "Infraorbital ethmoid (Haller's) cells: a panoramic radiographic study". Dentomaxillofacial Radiology. 41 (4): 305–308. doi:10.1259/dmfr/22999207. ISSN   0250-832X. PMC   3728998 . PMID   22241882.
  9. Srinivas, C. V.; Kauser, Safina (October 2022). "Anatomy and Variations of Onodi Cells and Haller Cells: A HRCT Cum Clinical Analysis in Sinonasal Disease and Polyposis". Indian Journal of Otolaryngology and Head & Neck Surgery. 74 (Suppl 2): 1683–1689. doi:10.1007/s12070-021-02828-x. ISSN   2231-3796. PMC   9702225 . PMID   36452524.
  10. Cherla, Deepa V.; Tomovic, Senja; Liu, James K.; Eloy, Jean Anderson (2013). "The central Onodi cell: A previously unreported anatomic variation". Allergy & Rhinology. 4 (1): e49–e51. doi:10.2500/ar.2013.4.0047. ISSN   2152-6575. PMC   3679569 . PMID   23772328.
  11. Human Anatomy, Jacobs, Elsevier, 2008, page 210