Endoscopic anatomy of nose and sphenoid sinus

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Endoscopic Anatomy of NOSE & Sphenoid sinusDr ZEESHAN AHMADSR (Neuro-otology)Department of NeurosurgerySGPGIMS, Lucknow

Septum

HADAD

Lateral wallTurbinates

Meati

Ostia

Lateral wallInferior turbinate separate boneInferior meatus NLD opening

Lateral wallMiddle turbinate attachment planesMiddle meatus intricate anatomyUncinateHiatus InfundibulumBulla ethmoidalisMaxillary osFrontal recess

Lateral wall

Lateral wallSuperior turbinate olfactory epitheliumSupeior meatus posterior ethmoids

Supreme turbinate sometimes

Lateral wall

Lateral wall

Lateral wall

Lateral wall

Lateral wall

Lateral wall

Blood supply of nose - septum

Blood supply of nose - lateral wall

Blood supply of noseSphenopalatinePosterior lateral nasalNasoseptalVidianDescending palatine

Blood supply of nose

Diagnostic nasal endoscopyFirst passVestibuleNasal valveInferior turbinateChoanaNasopharynx post and superior wallEustachian tubeContralateral ET and Rosenmuller recessInferior meatus and NLD

Diagnostic nasal endoscopySecond passChoana upper edgeSphenoethmoidal recessSuperior and supreme turbinatesSphenoid ostiumPosterior aspect of olfactory fossa

Diagnostic nasal endoscopyThird passSphenopalatine areaUncinate processHiatus semilunarisMaxillary os acc/natEthmoial infundibulumEthmoidal bullaFrontal recessOlfactory fossa anterior aspect

Sphenoid sinusLocationPneumatizationSepta (optic 7%, ICA 40%)OnodiOstiumLandmarks

location

pneumatizationConchal 3%Presellar 11%Sellar 59%Mixed 27%

---Extensive

pneumatization

SeptaNever midline(optic 7%, ICA 40%)

onodi

onodi

ostium

landmarks

landmarks

landmarks

landmarks

landmarks

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