Dr.

MANISH
MAXILLARY SINUS

Dr.MANISH
 contents,,
 introduction  maxillary
sinus
 paranasal  development
sinus  anatomy
 development
 histology
 types
 functional
 Ostium
importance
 function
 anomalies
Dr.MANISH
 ?
sinus ??
from
???...
LATIN
sinus: fold or
pocket
t
i.e.,ogthe front
pocket
a in a
Dr.MANISH
 paranasal
sinuses
(synonyms: sinus paranasales, nasal
sinus)
 development - 3rd week
of gestation
 paired
air-filled

 adjacent to the nasal

cavity
Dr.MANISH
 type 4
s pairs
frontalsinuses -
forehead bone
maxillary sinuses –
maxilla
ethmoidsinuses -
between eyes and nose
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ethmoid frontal
sinus sinus

superi
or
conch
a
ostiu middl
m e
conch
maxillary a
inferi
sinus or
conc
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ha
front ethmoid
al sinus
sinus
spheno
id sinus

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 clinical
classification

2 groups
anterior: frontal, maxillary, ante. ethmoid
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posterior: sphenoid, post. ethmoid
 draina through
ge: ostium
posteriorethmoid -
superior meatus
anterior ethmoid - middle
meatus
maxillary - middle meatus
frontal - middle meatus
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Dr.MANISH
 functions,
,,
 skull weight
 resonance of the voice
 absorbing shock(blow to the
 humidifying andface)
heating of
inhaled air
 insulates dental roots and eyes
from temperature fluctuations in
the nose
 regulation of intranasal pressure
Dr.MANISH
 artery: internal & external
carotid artery facial &
maxillary artery
 veins: facial, pharyngeal
plexus, pterygoid plexus
 lymph: submandibular,
retropharyngeal & upper
deep cervical nodes

blood Dr.MANISH
nerve:
trigeminal
i.e.,
nasociliary
nasopalatin
e maxillary
Dr.MANISH
 maxillary
sinus Antrum of
synonyms:
Highmore
Maxillary Antrum
maxillary sinus is the pneumatic
space that is lodged inside the
body of the maxilla and that
communicates with the
environment by the way of the
middle nasal meatus and the
Dr.MANISH
 . .. … …
history

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Galen (AD 130-201)
described 1st
Leonardo da Vinci
(1452-1519)
Nathaniel structure &
function
Highmore
 in
1651- 1st to describe
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Dr.MANISH
embry
Ö
logy

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3rd
month of
gestation
ectodermal
invagination
into middle
meatus
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fusion - palatal shelves +
nasal septum

expansion of lateral nasal

wall
(lateral nasal wall -
cartilagenous)
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 3 nasal conchae + 3 nasal
meatuses
(concha - projection / meatus
- spaces)

middle meatus expands into During

the lateral nasal wall & development
into
the maxillary air
bodyspaces invade and
expands maxilla
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causing cavity or
maxillary sinus recesses i.e.,
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1st to develop
 sizesmall
– pea
 at birth- 7X4X4 mm
 1st
Rapid growth - first 3
years
slower growth - until 7
years Dr.MANISH
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  largest
sinuses
 4 sided
pyramid

base-nasal wall
apex-zygoma
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boundaries

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 anteriorly
- facial
surface (cheek)
 posteriorly
-
infratemporal
surface
 superiorly – orbit
floor
 Inferiorly
-
alveolar &
ostiu
m,,

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maxillary sinus drains
into - middle
base ofmeatus
the
sinus is thin &
has
perforations
called ostium
ostium
hiatus located
in
semilunaris
o opening 1-
hiatus – open
lowersemilunar
part
Dr.MANISH –½
moon
 ostium’s average
opening
2.4 mm

 in
the articulated
skull opening is
reduced (3-4 mm) by
the following bones :
o above- uncinate
process of ethmoid
o below- ethmoidal
process of the inferior
nasal concha
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o behind-vertical part of
Volume-15 ml

sinus
dimension:
o height- 33
mm
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o width- 23-25
 Alvolopalatine recess reduces
space between sinus and tooth
root i.e., 1st molar,
followed by 2nd – 1st premolar and
2nd molar
Fully developed
alveolar recess – 3
fossa
o anterior fossa-
premolar buds
o middle fossa- molar
buds
o posterior fossa – 3rd
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molar bud
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histolog
y…

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pseudostratified ciliated columnar
epithelium

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 o
ciliated columnar
4 cell epithelial cells-
types 50-200 cilia per
cell
non-cilliated
o
cells- have
microvilli, more
basal
near the ostium.
goblet cells-
o
function is
unknown.
o cells-
produce
mucus flow patterns described by-
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histochemi
stry

mucous cells- +ve for alcian blue 8GX

procedure for acid sialomucin /
sulfomucin, produce electron lucent,
heterogeneous secretory material
serous cells- ninhydrin-Schiff & sudan black
produces electron dense, homogeneous
secretory materialDr.MANISH
Artery: facial,
infraorbital, greater
palatine

Veins: facial, pterygoid

plexus submandibular
Lymph:
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 Nerve
supply

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 middle
sup
alveola
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inical implications

Dr.MANISH
 o sinusitis- infection
(nose / caries)
o exodontia– (during
extraction) tooth apex–
upper 1st molar-
oralantral fistula
o hypercementosis of
root apex– while
extraction causes
perforation of sinus
wall.
radiographs must
o radicular cyst,
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periapical
 inflammation –
perforation of the sinus floor,
coz floor of the sinus is thin
pituitary
 gigantism – large
sinus
congenital syphilis
 -
suppressed maxillary sinus
Malignancy
 –
adenocarcinoma, squamous
cell carcinoma,
osteosarcoma, fibrosarcoma,
lymphosarcoma.
(c/f: 1st manifestation
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in
 sinus
wall crossed by
nerves-
o roof-infraorbital
o anterior- anterior superior
alveolar
o lateral- middle superior
alveolar
o posterior- posterior
superior alveolar
o posteriomedially- lesser
neuralgia
palatineDr.MANISH
anomal
ies

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 aplasia-complete absence
agenesis-(Defective
development resulting in
the absence of all or part
of an organ or tissue)
hypoplasia–
 altered/under
development sinuses–
supernumerary

2 middle meatus
i.e., middle and superior
and middle and inferior
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