Schneiderian membrane

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1) Edentulous area of two missing teeth is being prepared for future placement of dental implants with a lateral window sinus lift; incisions into the soft tissue are shown here.
2) The soft tissue is flapped back to expose the underlying lateral wall of the left maxillary sinus.
3) The bone has been removed with a piezoelectric instrument, exposing the underlying Schneiderian membrane, which is the lining of the maxillary sinus cavity.
4) Through careful instrumentation, the membrane is carefully peeled from the inner aspect of the sinus cavity.
5) The membrane has been reflected from the internal aspect of the inferior portion of the sinus cavity; one can now visualize the bony floor of the sinus cavity without its lining membrane (note the triangular ridge of bone within the sinus, known as an Underwood's septum).
6) The newly formed space within the bony cavity of the sinus yet inferior to the intact membrane is grafted with human cadaver allograft bone. The floor of the sinus will now be roughly 10mm or so more superior than it was before, providing enough room to place dental implants into the edentulous site. Lateral window sinus lift.jpg
1) Edentulous area of two missing teeth is being prepared for future placement of dental implants with a lateral window sinus lift; incisions into the soft tissue are shown here.
2) The soft tissue is flapped back to expose the underlying lateral wall of the left maxillary sinus.
3) The bone has been removed with a piezoelectric instrument, exposing the underlying Schneiderian membrane, which is the lining of the maxillary sinus cavity.
4) Through careful instrumentation, the membrane is carefully peeled from the inner aspect of the sinus cavity.
5) The membrane has been reflected from the internal aspect of the inferior portion of the sinus cavity; one can now visualize the bony floor of the sinus cavity without its lining membrane (note the triangular ridge of bone within the sinus, known as an Underwood's septum).
6) The newly formed space within the bony cavity of the sinus yet inferior to the intact membrane is grafted with human cadaver allograft bone. The floor of the sinus will now be roughly 10mm or so more superior than it was before, providing enough room to place dental implants into the edentulous site.

In anatomy, the Schneiderian membrane is the membranous lining of the maxillary sinus cavity. [1] Microscopically there is a bilaminar membrane with pseudostratified ciliated columnar epithelial cells on the internal (or cavernous) side and periosteum on the osseous side. The size of the sinuses varies in different skulls, and even on the two sides of the same skull. [2] This membrane is present in the nasal chamber which helps to smell (olfactory receptor)

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Maxillary sinus

The pyramid-shaped maxillary sinus is the largest of the paranasal sinuses, and drains into the middle meatus of the nose through the osteomeatal complex.

Cavernous sinus

The cavernous sinus within the human head is one of the dural venous sinuses creating a cavity called the lateral sellar compartment bordered by the temporal bone of the skull and the sphenoid bone, lateral to the sella turcica.

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The ophthalmic nerve is the first branch of the trigeminal nerve. The ophthalmic nerve is a sensory nerve mostly carrying general somatic afferent fibers that transmit sensory information to the CNS from structures of the eyeball, the skin of the upper face and anterior scalp, the lining of the upper part of the nasal cavity and air cells, and the meninges of the anterior cranial fossa. Some of ophthalmic nerve branches also convey parasympathetic fibers.

Frontal sinus one of the four pairs of paranasal sinuses that are situated behind the brow ridges

The frontal sinuses are one of the four pairs of paranasal sinuses that are situated behind the brow ridges. Sinuses are mucosa-lined airspaces within the bones of the face and skull. Each opens into the anterior part of the corresponding middle nasal meatus of the nose through the frontonasal duct which traverses the anterior part of the labyrinth of the ethmoid. These structures then open into the semilunar hiatus in the middle meatus.

Ethmoidal labyrinth consists of a number of thin-walled cellular cavities

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.

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Maxillary hiatus cranial conduit

Below the bulla ethmoidalis, and partly hidden by the inferior end of the uncinate process of ethmoid bone, is the maxillary hiatus ; in a frontal section this opening is seen to be placed near the roof of the sinus. In the articulated skull this aperture is much reduced in size by the following bones: the uncinate process of the ethmoid above, the ethmoidal process of the inferior nasal concha below, the vertical part of the palatine behind, and a small part of the lacrimal above and in front; the sinus communicates with the middle meatus of the nose, generally by two small apertures left between the above-mentioned bones.

Sinus lift

Maxillary sinus floor augmentation is a surgical procedure which aims to increase the amount of bone in the posterior maxilla, in the area of the premolar and molar teeth, by lifting the lower Schneiderian membrane and placing a bone graft.

Human nose feature of the face

The human nose is the most protruding part of the face. It bears the nostrils and 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. On average the nose of a male is larger than that of a female.

A sinus is a sac or cavity in any organ or tissue, or an abnormal cavity or passage caused by the destruction of tissue. In common usage, "sinus" usually refers to the paranasal sinuses, which are air cavities in the cranial bones, especially those near the nose and connecting to it. Most individuals have four paired cavities located in the cranial bone or skull.

Le Fort fracture of skull

A Le Fort fracture of the skull is a classic transfacial fracture of the midface, involving the maxillary bone and surrounding structures in either a horizontal, pyramidal or transverse direction. The hallmark of Lefort fractures is traumatic pterygomaxillary separation, which signifies fractures between the pterygoid plates, horseshoe shaped bony protuberances which extend from the inferior margin of the maxilla, and the maxillary sinuses. Continuity of this structure is a keystone for stability of the midface, involvement of which impacts surgical management of trauma victims, as it requires fixation to a horizontal bar of the frontal bone. The pterygoid plates lie posterior to the upper dental row, or alveolar ridge, when viewing the face from an anterior view. The fractures are named after French surgeon René Le Fort (1869–1951), who discovered the fracture patterns by examining crush injuries in cadavers.

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Underwoods septa

In anatomy, Underwood's septa are fin-shaped projections of bone that may exist in the maxillary sinus, first described in 1910 by Arthur S. Underwood, an anatomist at King's College in London. The presence of septa at or near the floor of the sinus are of interest to the dental clinician when proposing or performing sinus floor elevation procedures because of an increased likelihood of surgical complications, such as tearing of the Schneiderian membrane.

Endoscopic endonasal surgery is a minimally invasive technique used mainly in neurosurgery and otolaryngology. A neurosurgeon or an otolaryngologist, using an endoscope that is entered through the nose, fixes or removes brain defects or tumors in the anterior skull base. Normally an otolaryngologist performs the initial stage of surgery through the nasal cavity and sphenoid bone; a neurosurgeon performs the rest of the surgery involving drilling into any cavities containing a neural organ such as the pituitary gland.

References

  1. Boyne, P; James, RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Maxillofac Surg 1980;38:113–116.
  2. Bell, G. W.; Joshi, B. B.; Macleod, R. I. (February 2011). "Maxillary sinus disease: diagnosis and treatment". British Dental Journal. 210 (3): 113–118. doi: 10.1038/sj.bdj.2011.47 . ISSN   0007-0610. PMID   21311531.