Anat Cell Biol.  2024 Sep;57(3):463-467. 10.5115/acb.24.023.

Middle meatal nasal recesses of the maxillary sinuses and dangerously modified nasal anatomy

• Rusu MC
• Mureşan AN
• Dandoczi CA
• Vrapciu AD

• KMID: 2559767
• DOI: http://doi.org/10.5115/acb.24.023

Abstract

Pneumatisation of the maxillary sinus (MS) is variable. The archived cone-beam computed tomography file of a 54-year-old female was retrospectively evaluated anatomically. Nasal or retrobullar recesses of the MSs (NRMS) were found. The MSs were bicameral. NRMSs extended from the postero-lateral chambers of the MSs into the lateral nasal walls. The right NRMS was reached superior to the middle turbinate and the ethmoidal bulla was applied on its anterior side. The left NRMS had two medial pouch-like ends, one beneath the ethmoidal bulla and the other on the anterior side of the basal lamella of the middle turbinate. Additional anatomical findings were the uncinate bulla, infraorbital recesses of the MS, maxillary recess of the sphenoidal sinus, and atypical posterior insertions of the superior nasal turbinates, maxillo-ethmoidosphenoidal and ethmoido-sphenoidal. The NRMS is a novel finding and could lead to erroneous endoscopic corridors if not documented before the interventions.

Keyword

Nasal cavity; Turbinates; Paranasal sinuses; Maxilla; Ethmoid bone

Figure

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  Fig. 1 Three-dimensional volume renderings. (A) Posterior view of the maxillary sinuses (MSs), posterior walls removed. (B) Superior view of the MSs, roofs removed. (C) Anterior view of the MSs, anterior walls removed. (D) Lateral view of the medial wall of the right MS. (E) Infero-lateral view of the medial wall of the left MS. (F) Medial view of the left lateral nasal wall. (G) Medial view of the right lateral nasal wall. Legends 1–21 indicate right-side landmarks. Legends 22–41 indicate left-side landmarks. 1. Infraorbital canal; 2. oblique intrasinus septum; 3. postero-lateral chamber of the MS; 4. medial infraorbital recess; 5. prelacrimal recess; 6. lacrimonasal canal; 7. retrolacrimal recess; 8. lateral infraorbital recess; 9. uncinate process; 10. uncinate bulla; 11. main drainage ostium of the right MS; 12. posterior Haller cells; 13. sphenoidal recess of the MS; 14. nasal recess of the MS; 15. middle nasal turbinate; 16. semilunar hiatus; 17. ethmoidal bulla; 18. basal lamella of the middle nasal turbinate; 19. Santorini’s supreme nasal turbinate; 20. superior nasal turbinate; 21. floor of the sphenoidal sinus; 22. infraorbital canal; 23. oblique intrasinus septum; 24. air cell of the intrasinus septum; 25. the slit-like passage between the chambers of the MS; 26. postero-lateral chamber of the MS; 27. lateral infraorbital recess; 28. medial infraorbital recess; 29. prelacrimal recess; 30. lacrimonasal canal; 31. retrolacrimal recess; 32. uncinate process; 33. uncinate bulla; 34. main drainage ostium of the left MS; 35. nasal recess of the MS; 36. middle nasal turbinate; 37. semilunar hiatus; 38. ethmoidal bulla; 39. basal lamella of the middle nasal turbinate; 40. anterior medial end of the nasal recess of the MS; 41. posterior medial end of the nasal recess of the MS.

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  Fig. 2 Anterior views of coronal two-dimensional anterior-to-posterior slices (A–D) through the nasal turbinates. The thick arrows indicate the nasal recesses of the maxillary sinuses. 1. right inferior turbinate; 2. right middle turbinate; 3. right superior turbinate; 4. Santorini’s supreme turbinate; 5. left inferior turbinate; 6. left middle turbinate; 7. left superior turbinate; 8. sphenoidal sinuses; 9, 9’. non-lamellar base of the pterygoid process; 10, 10’. vidian canal.

Reference

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