OtoRhinoLaryngology Portal

The Leading Online Gallery of Otolaryngology and Head & Neck Surgery Specialty

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Nasal Vestibule and Valve Area

V- vestibule, S- septum, IT- inferior turbinate, arrows- mucocutaneus junction.

Normal Nasal Cavity on Anterior Rigid Endoscopy

V- vestibule,, F- floor or nose, S- nasal septum,

IT- inferior turbinate, MT- middle turbinate.

 

Watch video of normal nasal cavity on endoscopic examination @ YouTube

Nasal Cavity Appearance after Topical Decongestion Spray

 

Topical nasal spray or drops which contains sympathomimetic agent causes vasoconstriction  of the underlying vessels typically found abundantly in the inferior turbinates.  It improves nasal patency and reduces airway resistance .  However, prolonged usage predisposes to rebound congestion and resultant blockage.

 

Other substances which cause similar decongestant effect include opiods and its derivatives such as cocaine and Co-Phenylcain which are frequently used in otolaryngology procedures and surgery (especially endonasal). 

 

Decongestion improves visibility and appreciation

of anatomical/pathological details and better tolerance by the patient.

 

[Note middle turbinate anomaly in above figure.  The middle turbinate

is not directly seen from this distance in most cases without prior decongestion]

 

High definition endoscopic view of right nasal cavity.

 

 High definition endoscopic view of left nasal cavity.

Nasolabial Cyst

Fullness and obliteration of left nasolabial fold (as outlined) due to underlying nasolabial cyst. 
 
Nasal endoscopy view of left nasal cavity of the same patient showing a swelling with a normal overlying mucosa.  [V - vestibular skin, S - nasal septum, NC - nasolabial cyst] 
Intraoperative view of the cyst.
The cyst specimen removed from the patient.
Day 3 postoperative view showing regained nasolabial sulcus.  No scar is seen as the approach of surgery was via sublabial incision.

Olfactory Cleft

Rounded rectangle- olfactory cleft,

PE- perpendicular plate of ethmoid, MT- middle turbinate.

 

The Normal Lateral Nasal Wall

The Superior Turbinate

       Probable pneumatized superior            Normal superior turbinate turbinate

                   turbinate (star).                                  barey visible (oval).

Natural Maxillary Sinus Ostium

Accessory Maxillary Ostium

The Sphenoid Sinus Ostium

     

N- nasopharynx, yellow arrow- eustachian tube opening, white arrows- sphenoid sinus ostium, ST- superior turbinate, MT- middle turbinate, IT- inferior turbinate.

[Left figure- right non-operated, right figure- post-operative view]

 

Figure showing a widely patent right sphenoid sinus ostium (arrow).

[N- nasopharynx, S- nasal septum]

 

 

Arrowhead ball- sphenoid sinus ostium.

Sphenoid Sinus Anatomy: Intraoperative

OP- optic nerve protuberance, CP- internal carotid artery protuberance,

O- optic nerve, PS- planum sphenidale, SF- sella floor, CL- clivus,

star- intersphenoid septa, arrow- opticocarotid recess.

Stars- internal carotid artery, squares- optic nerve.

The Nasopharynx as Seen by Using Transnasal Nasopharyngoscopy Technique: Normal & Its Variations

The posterior nasal cavity-nasopharynx junction.

Smooth appearance without obvious lymphoid tissue.

Mild lymphoid hyperplasia involving roof and torus tubarius bilaterally.

Corrugated/rugae appearance of posterior nasopharyngeal wall.

Another undulated/wavy appearance of nasopharyngeal mucosa.

Rounded rectangle - favourite site of epistaxis in uncontrolled hypertension.  (IT - tail of inferior turbinate, TT - torus tubarius, V - vomer, N - posterior nasopharyngeal wall, SP - rostral surface of soft palate, arrow - Eustachian tube opening)

Fossa of Rossenmuller

This is a groove located behind torus tubarius or salpingopharyngeal fold on either side of nasopharynx (ellipse).  Nasopharyngeal carcinoma (NPC) formation begins here with fullness, groove obliteration, and eventually becomes obvious tumour with or without ulceration. 

[Arrow points to nasopharyngeal Eustachian tube opening]

The Nasopharynx In The Elderly

An Irradiated Nasopharynx with Eustachian Tube Opening In-Focus

Close-up view of left nasopharyngeal Eustachian tube opening in a patient irradiated for nasopharyngeal carcinoma.  (N - posterior wall of nasopharynx, X - visible cartilage of Eustachian tube opening, arrow -direction leading to middle ear).  Compare it with normal below.

Skull Bones

Bony Anatomy of Mid-Face and The Orbit

 

1-nasal bone, 2 frontal process of maxilla, 3- lacrimal bone, 4- ethmoid bone,

5- sphenoid bone, 7- zygomatic process of temporal bone, 8- nasal process of frontal bone, blue arrow- optic canal, red arrow- superior orbital fissure, yellow arrow- inferior orbital fissure, green arrow- infraorbital canal.

Inferior Meatus as Seen on Skull Model

 

C- maxillary crest, V- vomer, IM- inferior meatus, IC- inferior concha, MC- middle concha, star rubber marker leading to nasolacrimal duct opening (arrow).

Bony Anatomy of Posterior Nasal Cavity and Nasopharynx: The Vessels Foramina

Red arrow- sphenopalatine foramen.          Yellow arrow- carotid canal,

    V- vomer, MC-middle concha,      Black arrow leads to bony eustachian canal.

          IC- inferior concha, 

         MM- middle meatus.

The Maxillary Artery

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