Sphenoidal sinus
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The sphenoid sinus is a paired paranasal sinus occurring within the within the body of the
sphenoid bone The sphenoid bone is an unpaired bone of the neurocranium. It is situated in the middle of the skull towards the front, in front of the basilar part of the occipital bone. The sphenoid bone is one of the seven bones that articulate to form the o ...
. It represents one pair of the four paired
paranasal sinus Paranasal sinuses are a group of four paired air-filled spaces that surround the nasal cavity. The maxillary sinuses are located under the eyes; the frontal sinuses are above the eyes; the ethmoidal sinuses are between the eyes and the spheno ...
es.Illustrated Anatomy of the Head and Neck, Fehrenbach and Herring, Elsevier, 2012, page 64 The pair of sphenoid sinuses are separated in the middle by a septum of sphenoid sinuses. Each sphenoid sinus communicates with the
nasal cavity The nasal cavity is a large, air-filled space above and behind the nose in the middle of the face. The nasal septum divides the cavity into two cavities, also known as fossae. Each cavity is the continuation of one of the two nostrils. The nasal ...
via the opening of sphenoidal sinus. The two sphenoid sinuses vary in size and shape, and are usually asymmetrical.


Anatomy

On average, a sphenoid sinus measures 2.2 cm vertical height, 2 cm in transverse breadth; and 2.2 cm antero-posterior depth. Each spehoid sinus is contained within the
body of sphenoid bone The body of the sphenoid bone, more or less cubical in shape, is hollowed out in its interior to form two large cavities, the sphenoidal sinuses, which are separated from each other by a septum. Superior surface The superior surface of the bod ...
, being situated just inferior to the
sella turcica The sella turcica ( Latin for 'Turkish saddle') is a saddle-shaped depression in the body of the sphenoid bone of the human skull and of the skulls of other hominids including chimpanzees, gorillas and orangutans. It serves as a cephalometr ...
. The two sphenoid sinuses are separated medially by the septum of sphenoidal sinuses (which is usually asymmetrical). An opening of sphenoidal sinus forms a passage between each sphenoidal sinus, and the
nasal cavity The nasal cavity is a large, air-filled space above and behind the nose in the middle of the face. The nasal septum divides the cavity into two cavities, also known as fossae. Each cavity is the continuation of one of the two nostrils. The nasal ...
. Posteriorly, an opening of sphenoidal sinus opens into the sphenoidal sinus by an aperture high on the anterior wall the sinus; anteriorly, an opening of sphenoidal sinus opens into the roof of the
nasal cavity The nasal cavity is a large, air-filled space above and behind the nose in the middle of the face. The nasal septum divides the cavity into two cavities, also known as fossae. Each cavity is the continuation of one of the two nostrils. The nasal ...
via an aperture on the posterior wall of the sphenoethmoidal recess (occurring just superior the
choana The choanae (singular choana), posterior nasal apertures or internal nostrils are two openings found at the back of the nasal passage between the nasal cavity and the throat in tetrapods, including humans and other mammals (as well as crocodili ...
).Human Anatomy, Jacob, Elsevier, 2008, page 211


Innervation

The mucous membrane receives sensory innervation by the
posterior ethmoidal nerve The posterior ethmoidal nerve is a nerve of the orbit around the eye. It is a branch of the nasociliary nerve from the ophthalmic nerve (CN V1). It supplies sensation to the sphenoid sinus, the ethmoid sinus, and part of the dura mater in the ...
s (branch of the
ophthalmic nerve The ophthalmic nerve (V1) is a sensory nerve of the face. It is one of three divisions of the trigeminal nerve (CN V). It has three branches that provide sensory innervation to the eye, the skin of the upper face, and the skin of the anterior sc ...
), and
postganglionic In the autonomic nervous system, fibers from the ganglion to the effector organ are called postganglionic fibers. Neurotransmitters The neurotransmitters of postganglionic fibers differ: * In the parasympathetic division, neurons are ''chol ...
parasympathetic The parasympathetic nervous system (PSNS) is one of the three divisions of the autonomic nervous system, the others being the sympathetic nervous system and the enteric nervous system. The enteric nervous system is sometimes considered part of ...
fibers of the
facial nerve The facial nerve, also known as the seventh cranial nerve, cranial nerve VII, or simply CN VII, is a cranial nerve that emerges from the pons of the brainstem, controls the muscles of facial expression, and functions in the conveyance of taste ...
that
synapse In the nervous system, a synapse is a structure that permits a neuron (or nerve cell) to pass an electrical or chemical signal to another neuron or to the target effector cell. Synapses are essential to the transmission of nervous impulses from ...
d at the
pterygopalatine ganglion The pterygopalatine ganglion (aka Meckel's ganglion, nasal ganglion, or sphenopalatine ganglion) is a parasympathetic ganglion found in the pterygopalatine fossa. It is largely innervated by the greater petrosal nerve (a branch of the facial ner ...
which controls
secretion 440px Secretion is the movement of material from one point to another, such as a secreted chemical substance from a cell or gland. In contrast, excretion is the removal of certain substances or waste products from a cell or organism. The classic ...
of
mucus Mucus ( ) is a slippery aqueous secretion produced by, and covering, mucous membranes. It is typically produced from cells found in mucous glands, although it may also originate from mixed glands, which contain both serous and mucous cells. It ...
.


Anatomical relations

Proximal structures include: the optic canal and
optic nerve In neuroanatomy, the optic nerve, also known as the second cranial nerve, cranial nerve II, or simply CN II, is a paired cranial nerve that transmits visual information from the retina to the brain. In humans, the optic nerve is derived fro ...
,
internal carotid artery The internal carotid artery (Latin: arteria carotis interna) is an artery in the neck which supplies the anterior circulation of the brain. In human anatomy, the internal and external carotids arise from the common carotid arteries, where these ...
,
cavernous sinus The cavernous sinus within the human head is one of the dural venous sinuses creating a cavity called the lateral sellar compartment bordered by the temporal bone of the skull and the sphenoid bone, lateral to the sella turcica. Structure The cave ...
,
trigeminal nerve In neuroanatomy, the trigeminal nerve ( lit. ''triplet'' nerve), also known as the fifth cranial nerve, cranial nerve V, or simply CN V, is a cranial nerve responsible for sensation in the face and motor functions such as biting and che ...
,
pituitary gland In vertebrate anatomy, the pituitary gland, or hypophysis, is an endocrine gland, about the size of a chickpea and weighing, on average, in humans. It is a protrusion off the bottom of the hypothalamus at the base of the brain. The h ...
, and the
anterior ethmoidal cells The ethmoid sinuses or ethmoid air cells of the ethmoid bone are one of the four paired paranasal sinuses. The cells are variable in both size and number in the lateral mass of each of the ethmoid bones and cannot be palpated during an extraoral e ...
.


Anatomical variation

The sphenoid sinuses vary in size and shape, and, owing to the lateral displacement of the intervening
septum In biology, a septum (Latin for ''something that encloses''; plural septa) is a wall, dividing a cavity or structure into smaller ones. A cavity or structure divided in this way may be referred to as septate. Examples Human anatomy * Interat ...
of sphenoid sinuses, are rarely symmetrical. When exceptionally large, the sphenoid sinuses may extend into the roots of the
pterygoid processes The pterygoid processes of the sphenoid (from Greek ''pteryx'', ''pterygos'', "wing"), one on either side, descend perpendicularly from the regions where the body and the greater wings of the sphenoid bone unite. Each process consists of a medi ...
or greater wings of sphenoid bone, and may invade the basilar part of the
occipital bone The occipital bone () is a cranial dermal bone and the main bone of the occiput (back and lower part of the skull). It is trapezoidal in shape and curved on itself like a shallow dish. The occipital bone overlies the occipital lobes of the cer ...
. The septum of the sphenoidal sinuses may be partially or completely absent. Additional incomplete septa may also be present.


Development

The sphenoidal sinuses are minute at birth; their main development takes place after puberty.


Clinical significance

The spehnoid sinuses cannot be palpated during an extraoral examination. A potential complication of sphenoidal sinusitis is
cavernous sinus thrombosis The cavernous sinus within the human head is one of the dural venous sinuses creating a cavity called the lateral sellar compartment bordered by the temporal bone of the skull and the sphenoid bone, lateral to the sella turcica. Structure The ...
. If a fast-growing tumor erodes the floor of the sphenoidal sinus, the
vidian nerve The nerve of the pterygoid canal (Vidian nerve) is formed by the junction of the greater petrosal nerve and deep petrosal nerve, which passes from the foramen lacerum to the pterygopalatine fossa through the pterygoid canal. Structure The nerve ...
could be in danger. If the tumor spreads laterally, the
cavernous sinus The cavernous sinus within the human head is one of the dural venous sinuses creating a cavity called the lateral sellar compartment bordered by the temporal bone of the skull and the sphenoid bone, lateral to the sella turcica. Structure The cave ...
and all its constituent nerves could be in danger. An endonasal surgical procedure called a sphenoidotomy may be carried out to enlarge the sphenoid sinus, usually in order to drain it.


Transsphenoidal surgery

Because only thin shelves of bone separate the sphenoidal sinuses from the nasal cavities below and
hypophyseal fossa The sella turcica ( Latin for 'Turkish saddle') is a saddle-shaped depression in the body of the sphenoid bone of the human skull and of the skulls of other hominids including chimpanzees, gorillas and orangutans. It serves as a cephalometr ...
above, the
pituitary gland In vertebrate anatomy, the pituitary gland, or hypophysis, is an endocrine gland, about the size of a chickpea and weighing, on average, in humans. It is a protrusion off the bottom of the hypothalamus at the base of the brain. The h ...
can be surgically approached through the roof of the nasal cavities by first passing through the anterioinferior aspect of the sphenoid bone and into the sinuses, followed by entry through the top of the sphenoid bone into the
hypophyseal fossa The sella turcica ( Latin for 'Turkish saddle') is a saddle-shaped depression in the body of the sphenoid bone of the human skull and of the skulls of other hominids including chimpanzees, gorillas and orangutans. It serves as a cephalometr ...
.


References


External links

* * () {{Authority control Bones of the head and neck