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Anatomy of the Nose and Paranasal Sinuses
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Dustin M. Dalgorf, Richard J. Harvey
The uncinate process is a sickle-shaped bone which attaches inferiorly to the inferior turbinate and palatine bone, and anterosuperiorly to the lacrimal bone. The uncinate, together with a fold of mucosa called the anterior and posterior fontanelle, cover the opening to the maxillary sinus. Accessory ostia may be present in the fontanelle that can be mistaken for the true maxillary ostium. Failure to correctly identify the true ostia and connect it with the common sinus cavity may result in a phenomenon known as mucous recirculation. During recirculation, mucuus is directed towards the natural opening along the mucociliary drainage pathway and re-enters the sinus through the accessory ostium.
Ear, Nose, and Paranasal Sinus
Published in Swati Goyal, Neuroradiology, 2020
Best visualized in the coronal section, the OMC is the complex of structures that help in mucociliary and airflow drainage of the maxillary, anterior ethmoidal and frontal sinuses into the middle meatus. It consists of: The uncinate process – a hook-like process of the ethmoid bone in the lateral wall of the noseThe maxillary sinus with ostiaThe ethmoid bulla (the posterior-most cells of the anterior ethmoid complex)The ethmoidal infundibulumThe hiatus semilunaris – a semicircular opening in the lateral nasal wall
Otorhinolaryngology (ENT)
Published in Gozie Offiah, Arnold Hill, RCSI Handbook of Clinical Surgery for Finals, 2019
Local causes➣ Infective rhinitis or upper respiratory tract infection➣ Allergic or nonallergic rhinitis➣ Nasal polyposis➣ Retained foreign body➣ Anatomical variations (deviated nasal septum, abnormal uncinate process and turbinate hypertrophy)➣ Tumour➣ Fractures involving paranasal sinuses
In vivo analysis of endocanalicular light pipe transillumination in endoscopic dacryocystorhinostomy: Anatomic considerations and cautions for the transitioning
Published in Orbit, 2022
Nina S. Boal, Elizabeth A.Z. Cretara, Benjamin S. Bleier, Allen C. Lam, Daniel R. Lefebvre
The maxillary line is an endonasal mucosal projection that courses from the anterior middle turbinate attachment down along the lateral nasal wall to the dorsum of the inferior turbinate. It corresponds to the suture between the frontal process of the maxilla and lacrimal bone extranasally, and to the root of the uncinate process intranasally.8 The maxillary line is regarded as a reliable landmark from which to identify the location of the lacrimal sac along the lateral nasal wall during endo-DCR,8–12 along with the axilla and operculum of the middle turbinate.19 Nonetheless, placing a light pipe into the lacrimal sac to guide placement of the osteotomy is thought to be a helpful crutch for the surgeon transitioning to endoscopic technique as the individual becomes familiarized with intranasal anatomy.7,14 The use of a transillumination target was first described by Christensen in 1951,13 re-introduced by Massaro in 1990,5 and was subsequently widely reported as a useful technique in endo-DCR.6,7,11,12,14
Gustatory rhinitis in multiple system atrophy
Published in Acta Oto-Laryngologica Case Reports, 2021
Kaoru Yamakawa, Kenji Kondo, Akihiko Unaki, Hideto Saigusa, Kyohei Horikiri, Tatsuya Yamasoba
A 56-year-old man was referred to our department with a chief complaint of bilateral copious nasal discharge while eating. His symptoms first appeared 3 years ago. The watery nasal secretion was so excessive that he lost his appetite. Endoscopic and CT examinations in the previous clinic revealed a left nasal polyp at the uncinate process and mild opacity in bilateral maxillary and ethmoid sinuses. He therefore underwent left nasal polypectomy, but his symptom did not improve. Oral administration of antihistamines, including d-chlorpheniramine maleate and azelastine hydrochloride, failed to improve his condition. A fixed-dose combination of fexofenadine hydrochloride/pseudoephedrine hydrochloride, which was prescribed for sympathetic stimulation, was temporarily effective. However, the symptom recurred within a month.
A case of silent sinus syndrome following a history of multiple facial traumas
Published in Clinical and Experimental Optometry, 2021
Silent sinus syndrome (SSS) is a rare condition characterised by painless enophthalmos and hypoglobus (inferior displacement of the globe within the orbit) from collapse of the ipsilateral maxillary sinus and inferior displacement of the orbital floor. It is most often precipitated by negative pressure within the maxillary sinus caused by lateralisation of the ethmoidal uncinate process and complete obstruction of the ostiomeatal complex.1 Chronic sinus inflammation leads to bone remodelling and increased pliability of the orbital floor.2 Depending on the severity of globe displacement, patients may present as asymptomatic, with mild non‐specific symptoms, or with more obviously concerning progressive symptoms such as diplopia, facial paraesthesia, restricted gaze, or lid position abnormalities.3 This sinus condition, confirmed with computed tomography (CT), is ‘silent’ because it occurs in the absence of sinus symptoms or disease and is typically idiopathic. Less frequently, this condition may be post‐traumatic or iatrogenic.4 This clinical picture alerts primary eye‐care providers to the possibility of SSS months to years following facial trauma.