Theethmoid sinusesorethmoid air cellsof theethmoid boneare one of the four pairedparanasal sinuses.[1]Unlike the other three pairs of paranasal sinuses which consist of one or two large cavities, the ethmoidal sinuses entail a number of small air-filled cavities ( "air cells" ).[2]The cells are located within thelateral mass (labyrinth)of each ethmoid bone and are variable in both size and number.[1]The cells are grouped into anterior, middle, and posterior groups; the groups differ in their drainage modalities,[2]though all ultimately drain into either thesuperioror themiddle nasal meatus[3]of the lateral wall of the nasal cavity.
| Ethmoid sinus | |
|---|---|
 Frontal view ofparanasal sinuses | |
 Coronal section of nasal cavities. | |
| Details | |
| Nerve | Posterior ethmoidal nerve |
| Identifiers | |
| Latin | cellulae ethmoidales, labyrinthi ethmoidales |
| MeSH | D005005 |
| TA98 | A06.1.03.005 |
| TA2 | 3180 |
| FMA | 84115 |
| Anatomical terms of bone | |
Structure
editThe ethmoid air cells consist of numerous thin-walled cavities in theethmoidal labyrinth[4]that represent invaginations of the mucous membrane of the nasal wall into the ethmoid bone.[3]They are situated between the superior parts of thenasal cavitiesand theorbits,and are separated from these cavities by thin bony lamellae.[4]
There are 5-15 air cells in either ethmoid bone in the adult, with a combined volume of 2-3mL.[5]
Development
editThe ethmoidal cells (sinuses) andmaxillary sinusesare present at birth.[6]At birth, 3-4 air cells are present, with the number increasing to 5-15 by adulthood.[5]
Drainage
edit- Theanterior ethmoidal cellsdrain (directly or indirectly[3]) into themiddle nasal meatusby way of theethmoidal infundibulum.[4][3][5]
- Themiddle ethmoidal cellsdrain directly into themiddle nasal meatus.[3]
- Theposterior ethmoidal cellsdrain directly into thesuperior nasal meatus[3][5]at thesphenoethmoidal recess;[5]sometimes, one or more opens into thesphenoidal sinus.[4]
Lamellae
editThe ethmoidal labyrinth is divided by multiple obliquely oriented, parallel lamellae. The first lamellae is equivalent to theuncinate process of ethmoid bone,the second corresponds theethmoid bulla,and the third is the basal lamella, and the fourth is equivalent to thesuperior nasal concha.[5]
The anterior and posterior ethmoid cells are separated by thebasal lamella[7][5](also known as theground lamella).[5]It is one of the bony divisions of the ethmoid bone and is mostly contained inside theethmoid labyrinth.The basal lamella is continuous medially with the bonymiddle nasal concha.[7]Anteriorly, it vertically inserts into theethmoid crest;the middle part attaches obliquely into theorbital lamina of ethmoid bone (lamina papyricea)while the posterior part attaches into the orbital lamina horizontally.[5]
Innervation
editThe ethmoidal air cells receive sensory innervation from theanteriorand theposterior ethmoidalnerve (which are ultimately derived from theophthalmic branch (CN V1)of thetrigeminal nerve (CN V)),[3]and the orbital branches of thepterygopalatine ganglion,which carry the postganglionic parasympathetic nerve fibers for mucous secretion from thefacial nerve.[clarification needed][citation needed]
Haller cells
editHaller cells are air cells situated beneath theethmoid bullaalong the roof of themaxillary sinusand the most inferior portion of thelamina papyracea,including air cells located within theethmoid infundibulum.[8]These may arise from the anterior or posterior ethmoidal sinuses.[citation needed]
Onodi cells
editAlso known as a sphenoethmoidal air cell, an Onodi cell is a posterior ethmoidal air cell that lies superolateral to thesphenoid sinus,often extending into theanterior clinoid process.[9]Onodi cells are clinically significant because they lie in close proximity to theoptic nerveandinternal carotid artery,so surgeons should be aware of their existence when performing surgery on the sphenoid sinus so as not to damage these important structures.
A central Onodi air cell is a variation in which a posterior ethmoid cell lies superior to the sphenoid sinus in a midline position with at least one optic canal bulge.[10]
Clinical significance
editAcute ethmoiditis in childhood and ethmoidal carcinoma may spread superiorly causing meningitis and cerebrospinal fluid leakage or it may spread laterally into the orbit causingproptosisanddiplopia.[11]
Additional images
edit-
Ethmoid sinus. Ethmoidal air cells. Deep dissection. Superior view. -
Ethmoid sinus cancer that has spread to the lymph nodes
References
edit
This article incorporates text in thepublic domainfrompage 154of the 20th edition ofGray's Anatomy(1918)
- ^abIllustrated Anatomy of the Head and Neck, Fehrenbach and Herring, Elsevier, 2012, page 64
- ^abMorton, David A. (2019).The Big Picture: Gross Anatomy.K. Bo Foreman, Kurt H. Albertine (2nd ed.). New York. p. 246.ISBN978-1-259-86264-9.OCLC1044772257.
{{cite book}}:CS1 maint: location missing publisher (link) - ^abcdefgMoore, Keith L.; Dalley, Arthur F.; Agur, Anne M. R. (2017).Essential Clinical Anatomy(6th ed.). Lippincott Williams & Wilkins. p. 968.ISBN978-1496347213.
- ^abcdOtorhinolaryngology, Head and Neck Surgery, Anniko, Springer, 2010, page 188
- ^abcdefghiCappello, Zachary J.; Minutello, Katrina; Dublin, Arthur B. (2023),"Anatomy, Head and Neck, Nose Paranasal Sinuses",StatPearls,Treasure Island (FL): StatPearls Publishing,PMID29763001,retrieved2023-07-04
- ^Moore, K.L Et al(2014). Clinically Oriented Anatomy. Baltimore: Page960
- ^abHechl, Peter S.; Setliff, Reuben C.; Tschabitscher, Manfred (1997). "The ethmoid bone and middle turbinate".Endoscopic Anatomy of the Paranasal Sinuses.Springer Vienna. pp. 9–28.doi:10.1007/978-3-7091-6536-2_2.ISBN978-3-7091-7345-9.
- ^Raina, A; Guledgud, M V; Patil, K (May 2012)."Infraorbital ethmoid (Haller's) cells: a panoramic radiographic study".Dentomaxillofacial Radiology.41(4): 305–308.doi:10.1259/dmfr/22999207.ISSN0250-832X.PMC3728998.PMID22241882.
- ^Srinivas, C. V.; Kauser, Safina (October 2022)."Anatomy and Variations of Onodi Cells and Haller Cells: A HRCT Cum Clinical Analysis in Sinonasal Disease and Polyposis".Indian Journal of Otolaryngology and Head & Neck Surgery.74(Suppl 2): 1683–1689.doi:10.1007/s12070-021-02828-x.ISSN2231-3796.PMC9702225.PMID36452524.
- ^Cherla, Deepa V.; Tomovic, Senja; Liu, James K.; Eloy, Jean Anderson (2013)."The central Onodi cell: A previously unreported anatomic variation".Allergy & Rhinology.4(1): e49–e51.doi:10.2500/ar.2013.4.0047.ISSN2152-6575.PMC3679569.PMID23772328.
- ^Human Anatomy, Jacobs, Elsevier, 2008, page 210
External links
edit- Anatomy figure: 33:04-07at Human Anatomy Online, SUNY Downstate Medical Center
- Anatomy photo:33:st-0711at the SUNY Downstate Medical Center
