1. Dr. Saad Al Asiri SURGICAL ANATOMY OF NOSE & PARANASAL SINUS by:
MD, DLO, KSF, Rhino
General Secretary Assistant for Training & Program Accreditation
ENT Consultant and Rhinologist

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28. Anatomy of the Nose Bony part Nasal pyramid consists of
Cartilages & bones
Covered by muscles & skin
Bony part
Upper one third is bony
Lower two - cartilaginous

29. Bony part - two nasal bones
Meet in the midline and rest on the upper part of nasal processes of frontal bone and are themself hold between the frontal processes of maxilla

30. Cartilaginous part Upper lateral cartilage Lower lateral "alar"
Lesser alar "Sesamoid"
Septal cartilage "Septum"

31. Nasal muscles Nasal skin Procerus Nasals levator labii superioris
Anterior & post dilator nares
Depressor septi
Nasal skin
Covered all muscles
Contain sebaceous glands
Rhinophyma

32. Common anomalies of nose
Anterior nasal atresia
Bifid nose & nose duplication
Congenital
Congenital nasal tumor, Encephalocele, glioma, dermid, haemangioma

33. Lymphatic Blood supply of external nose Facial artery Ophthalmic A
Infraorbital branch of maxillary A
Lymphatic
Submental
Submandibular
Pre-auricle LN

34. Nasal cavity Roof, floor, medial & lateral wall
Medial wall "septum" divides the nasal cavity into left & right nasal cavities
Nasal valve area of highest resistance triangular in shape bounded by septum, pyriform aperture and upper lateral cartilage

35. Why nasal valve is important plate
Roof
Cribriform of ethmoid
Front nasal bone
Inferior part of sphenoid bone
Floor
palatine processes of maxilla
post one third horizontal part of palatine bone

36. Septum Vomer - lower & post part of septum
Perpendicular plate of ethmoid - upper and anterior septum
Septal cartilage - quadrilateral in shape is wedged between the two bones
Other bones - above & front - nasal bone + nasal spine of frontal bone
Above & behind - rostrum & crest of sphenoid
Below is crest of maxilla & palatine bone

37. Blood Supply of Nasal Septum
External & internal carotid A.
Ex C A - spheno palatine A → maxilla A
branches of G. Palatin A → maxilla A
super labial → facial A
Internal C A - anterior & posterior ethmoid A

38. Little area
- sites
- arteries involve :
- sphenopalatine A
- anterior ethmoid A
- superior labial & great P A
- why this area is important?
Nerve supply of nasal septum

39. Lateral wall of the nose
- below and front by nasal surface of maxilla
- above by ethmoidal Labrinth
- posteriorly by plate of palatine bone
- the inferior turbinate is a separate bone
- turbinates & meati "three each"
- m meatus
- uncinate process
- O M complex
- inferior meatus
- nasolacrimal duct

40. Pterygopalatine fossa
- space located behind to the posterior wall of maxillary sinus
- communication
- content
Mucous membrane of nose
- vestibule - skin & hair follicle & sebaceous gland
- pseudostratified ciliated columns, types of epithelium & goblet cell, mucous, serious glands
Olfactory mucous membrane
-super T. + roof of nasal cavity and upper ICM of N. Septum

41. Blood supply of nasal cavity - anterior & posterior ethmoid A
- sphenopalatine A → maxilla A
-greater P.A. → maxilla A
- superior Lab A → facial A
Venous drainage "valveless" *
- anterior → cavernous sinus
- middle + post → pterygoid + pharyngeal plexus

42. -infraorbital → maxillary N → pterygo Platin ganglion
Nerve Supply
I. Sensory nerve supply
-infraorbital → maxillary N → pterygo Platin ganglion
-anterior superior alveolar N → maxilla N
-nasociliary N → anterior ethmoid

43. II. Secretomotor supply -vidian nerve - nerve of pterygoid canal
-vidian nerve is formed by
Greater superficial petrosal branch of facial nerve
Deep petrosal → plexus around internal carotid A.
III. Olfactory nerve

44. lymphatic drainage of nasal cavity
anterior part → submental + submandibular LN
Post part → upper deep cx LN

45. Paranasal Sinuses Anatomy*
Function of the nose
Respiration air filtered, heated, humidified
Olfaction
Vocal resonance of voice
Airway protection
Nasal cycle
Rhythmic congestion, decongestion of nasal mucosa
Role of nasal mucosa in evoke allergic reaction
Paranasal Sinuses Anatomy*

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