Paranasal sinuses are a group of four paired air-filled spaces that surround 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 nas ...

. The

maxillary sinus The pyramid-shaped maxillary sinus (or antrum of Nathaniel Highmore (surgeon), Highmore) is the largest of the paranasal sinuses, located in the maxilla. It drains into the middle meatus of the noseHuman Anatomy, Jacobs, Elsevier, 2008, page 209- ...

es are located under the

eye An eye is a sensory organ that allows an organism to perceive visual information. It detects light and converts it into electro-chemical impulses in neurons (neurones). It is part of an organism's visual system. In higher organisms, the ey ...

s; the

frontal sinus The frontal sinuses are one of the four pairs of paranasal sinuses that are situated behind the brow ridges. Sinuses are mucosa-lined airspaces within the bones of the face and skull. Each opens into the anterior part of the corresponding middle ...

es are above the eyes; the ethmoidal sinuses are between the eyes and the

sphenoidal sinus The sphenoid sinus is a paired paranasal sinus in the Body of sphenoid bone, body of the sphenoid bone. It is one pair of the four paired paranasal sinuses.Illustrated Anatomy of the Head and Neck, Fehrenbach and Herring, Elsevier, 2012, page 64 T ...

es are behind the eyes. The

sinuses 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 sphenoi ...

are named for the facial bones and sphenoid bone in which they are located. Their role is disputed.

Structure

Humans possess four pairs of paranasal sinuses, divided into subgroups that are named according to the

bone A bone is a rigid organ that constitutes part of the skeleton in most vertebrate animals. Bones protect the various other organs of the body, produce red and white blood cells, store minerals, provide structure and support for the body, ...

s within which the sinuses lie. They are all innervated by branches of the

trigeminal nerve In neuroanatomy, the trigeminal nerve (literal translation, lit. ''triplet'' nerve), also known as the fifth cranial nerve, cranial nerve V, or simply CN V, is a cranial nerve responsible for Sense, sensation in the face and motor functions ...

(CN V). * The

es, the largest of the paranasal sinuses, are under the

s, in the maxillary bones (open in the back of the semilunar hiatus of the nose). They are innervated by the

maxillary nerve In neuroanatomy, the maxillary nerve (V) is one of the three branches or divisions of the trigeminal nerve, the fifth (CN V) cranial nerve. It comprises the principal functions of Sense, sensation from the maxilla, nasal cavity, Sinus (anatomy ...

(CN V2). * The

es, superior to the eyes, in the

frontal bone In the human skull, the frontal bone or sincipital bone is an unpaired bone which consists of two portions.'' Gray's Anatomy'' (1918) These are the vertically oriented squamous part, and the horizontally oriented orbital part, making up the bo ...

, which forms the hard part of the

forehead In human anatomy, the forehead is an area of the head bounded by three features, two of the skull and one of the scalp. The top of the forehead is marked by the hairline, the edge of the area where hair on the scalp grows. The bottom of the fo ...

. They are innervated by the

ophthalmic nerve The ophthalmic nerve (CN V1) is a sensory nerve of the head. It is one of three divisions of the trigeminal nerve (CN V), a cranial nerve. It has three major branches which provide sensory innervation to the eye, and the skin of the upper face ...

(CN V1). * The

ethmoidal sinus The ethmoid sinuses or ethmoid air cells of the ethmoid bone are one of the four paired paranasal sinuses. Unlike the other three pairs of paranasal sinuses which consist of one or two large cavities, the ethmoidal sinuses entail a number of small ...

es, which are formed from several discrete air cells within the

ethmoid bone The ethmoid bone (; from ) is an unpaired bone in the skull that separates the nasal cavity from the brain. It is located at the roof of the nose, between the two orbits. The cubical (cube-shaped) bone is lightweight due to a spongy constructi ...

between the

nose A nose is a sensory organ and respiratory structure in vertebrates. It consists of a nasal cavity inside the head, and an external nose on the face. The external nose houses the nostrils, or nares, a pair of tubes providing airflow through the ...

and the eyes. They are innervated by the

ethmoidal nerves The ethmoidal nerves, which arise from the nasociliary nerve, supply the ethmoidal cells; the posterior branch leaves the orbital cavity through the posterior ethmoidal foramen and gives some filaments to the sphenoidal sinus. There are two ethmoi ...

, which branch from the

nasociliary nerve The nasociliary nerve is a branch of the ophthalmic nerve (CN V1) (which is in turn a branch of the trigeminal nerve (CN V)). It is intermediate in size between the other two branches of the ophthalmic nerve, the frontal nerve and lacrimal ner ...

of the ophthalmic nerve (CN V1). * The

es, in 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 occipital bone, basilar part of the occipital bone. The sphenoid bone is one of the seven bon ...

. They are innervated by the ophthalmic and maxillary nerve (CN V1 and V2). The paranasal sinuses are lined with

respiratory epithelium Respiratory epithelium, or airway epithelium, is ciliated pseudostratified columnar epithelium a type of columnar epithelium found lining most of the respiratory tract as respiratory mucosa, where it serves to moisten and protect the airways ...

(ciliated pseudostratified columnar epithelium).

Functions

One known function of the paranasal sinuses is the production of

nitric oxide Nitric oxide (nitrogen oxide, nitrogen monooxide, or nitrogen monoxide) is a colorless gas with the formula . It is one of the principal oxides of nitrogen. Nitric oxide is a free radical: it has an unpaired electron, which is sometimes den ...

, which also functions as a facilitator of oxygen uptake.

Development

Paranasal sinuses form developmentally through excavation of bone by air-filled sacs ( pneumatic diverticula) from the

. This process begins prenatally (intrauterine life), and it continues through the course of an organism's lifetime. The results of experimental studies suggest that the natural ventilation rate of a sinus with a single

sinus ostium The human nose is the first organ of the respiratory system. It is also the principal organ in the olfactory system. The shape of the nose is determined by the nasal bones and the nasal cartilages, including the nasal septum, which separate ...

(opening) is extremely slow. Such limited ventilation may be protective for the sinus, as it would help prevent drying of its mucosal surface and maintain a near-sterile environment with high

carbon dioxide Carbon dioxide is a chemical compound with the chemical formula . It is made up of molecules that each have one carbon atom covalent bond, covalently double bonded to two oxygen atoms. It is found in a gas state at room temperature and at norma ...

concentrations and minimal

pathogen In biology, a pathogen (, "suffering", "passion" and , "producer of"), in the oldest and broadest sense, is any organism or agent that can produce disease. A pathogen may also be referred to as an infectious agent, or simply a Germ theory of d ...

access. Thus composition of gas content in the maxillary sinus is similar to

venous blood Venous blood is deoxygenated blood which travels from the peripheral blood vessels, through the venous system into the right atrium of the heart. Deoxygenated blood is then pumped by the right ventricle to the lungs via the pulmonary artery whi ...

, with high carbon dioxide and lower

oxygen Oxygen is a chemical element; it has chemical symbol, symbol O and atomic number 8. It is a member of the chalcogen group (periodic table), group in the periodic table, a highly reactivity (chemistry), reactive nonmetal (chemistry), non ...

levels compared to breathing air. At birth, only the

and the

ethmoid sinus The ethmoid sinuses or ethmoid air cells of the ethmoid bone are one of the four paired paranasal sinuses. Unlike the other three pairs of paranasal sinuses which consist of one or two large cavities, the ethmoidal sinuses entail a number of small ...

are developed but not yet pneumatized; only by the age of seven are they fully aerated. The

sphenoid sinus The sphenoid sinus is a paired paranasal sinus in the body of the sphenoid bone. It is one pair of the four paired paranasal sinuses.Illustrated Anatomy of the Head and Neck, Fehrenbach and Herring, Elsevier, 2012, page 64 The two sphenoid sinuse ...

appears at the age of three, and the

es first appear at the age of six, and fully develop during adulthood.

CT scans, radiographs (x-ray) and other illustrations

File:CT Paranasal Sinuses Coronal MPR Soft Tissue Window.ogg, Coronal CT scan of the paranasal sinuses (soft tissue) File:CT Paranasal Sinuses Coronal MPR Bone Window.ogg, Coronal CT scan of the paranasal sinuses (bone) File:Paranasal sinuses radiograph occipitofrontal.jpg, Paranasal sinuses radiograph (occipitofrontal) File:Paranasal sinuses radiograph occipitomental.jpg, Paranasal sinuses radiograph (occipitomental) File:Paranasal sinuses radiograph lateral.jpg, Paranasal sinuses radiograph (lateral) File:3DPX-002305 Upper respiratory cast 3DFile Nevit Dilmen.stl, 3D cast of maxillary, frontal, ethmoid and sphenoid sinuses, nasal cavity and hypopharynx

Clinical significance

Inflammation

The paranasal sinuses are joined to the

via small orifices called ostia. These become blocked easily by allergic inflammation, or by swelling in the nasal lining that occurs with a

cold Cold is the presence of low temperature, especially in the atmosphere. In common usage, cold is often a subjectivity, subjective perception. A lower bound to temperature is absolute zero, defined as 0.00K on the Kelvin scale, an absolute t ...

. If this happens, normal drainage 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 fluid, serous and muc ...

within the sinuses is disrupted, and

sinusitis Sinusitis, also known as rhinosinusitis, is an inflammation of the mucous membranes that line the sinuses resulting in symptoms that may include production of thick nasal mucus, nasal congestion, facial congestion, facial pain, facial pressure ...

may occur. Because the maxillary posterior teeth are close to the maxillary sinus, this can also cause clinical problems if any disease processes are present, such as an infection in any of these teeth. These clinical problems can include secondary sinusitis, the inflammation of the sinuses from another source such as an infection of the adjacent teeth.Illustrated Anatomy of the Head and Neck, Fehrenbach and Herring, Elsevier, 2012, p. 68 These conditions may be treated with drugs such as

decongestant A decongestant, or nasal decongestant, is a type of pharmaceutical drug that is used to relieve nasal congestion in the upper respiratory tract. The active ingredient in most decongestants is either pseudoephedrine or phenylephrine (the latter o ...

s, which cause

vasoconstriction Vasoconstriction is the narrowing of the blood vessels resulting from contraction of the muscular wall of the vessels, in particular the large arteries and small arterioles. The process is the opposite of vasodilation, the widening of blood vesse ...

in the sinuses; reducing inflammation; by traditional techniques of

nasal irrigation Nasal irrigation (also called nasal lavage, nasal toilet, or nasal douche) is a personal hygiene practice in which the nasal cavity is washed to flush out mucus and debris from the nose and sinuses, in order to enhance nasal breathing. Nasal ir ...

; or by

corticosteroid Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex of vertebrates, as well as the synthetic analogues of these hormones. Two main classes of corticosteroids, glucocorticoids and mineralocorticoids, are invo ...

Cancer

Malignancies of the paranasal sinuses comprise approximately 0.2% of all malignancies. About 80% of these malignancies arise in the maxillary sinus. Men are much more often affected than women. They most often occur in the age group between 40 and 70 years.

Carcinoma Carcinoma is a malignancy that develops from epithelial cells. Specifically, a carcinoma is a cancer that begins in a tissue that lines the inner or outer surfaces of the body, and that arises from cells originating in the endodermal, mesoder ...

s are more frequent than

sarcoma A sarcoma is a rare type of cancer that arises from cells of mesenchymal origin. Originating from mesenchymal cells means that sarcomas are cancers of connective tissues such as bone, cartilage, muscle, fat, or vascular tissues. Sarcom ...

s. Metastases are rare. Tumours of the sphenoid and frontal sinuses are extremely rare.

Etymology

''Sinus'' is a

Latin Latin ( or ) is a classical language belonging to the Italic languages, Italic branch of the Indo-European languages. Latin was originally spoken by the Latins (Italic tribe), Latins in Latium (now known as Lazio), the lower Tiber area aroun ...

word meaning a fold, curve, or bay. Compare ''

sine In mathematics, sine and cosine are trigonometric functions of an angle. The sine and cosine of an acute angle are defined in the context of a right triangle: for the specified angle, its sine is the ratio of the length of the side opposite th ...

''.

Other animals

Paranasal sinuses occur in many other animals, including most

mammal A mammal () is a vertebrate animal of the Class (biology), class Mammalia (). Mammals are characterised by the presence of milk-producing mammary glands for feeding their young, a broad neocortex region of the brain, fur or hair, and three ...

bird Birds are a group of warm-blooded vertebrates constituting the class (biology), class Aves (), characterised by feathers, toothless beaked jaws, the Oviparity, laying of Eggshell, hard-shelled eggs, a high Metabolism, metabolic rate, a fou ...

s, and

crocodilia Crocodilia () is an order of semiaquatic, predatory reptiles that are known as crocodilians. They first appeared during the Late Cretaceous and are the closest living relatives of birds. Crocodilians are a type of crocodylomorph pseudosuchia ...

ns. They have also been discovered in non-avian

dinosaur Dinosaurs are a diverse group of reptiles of the clade Dinosauria. They first appeared during the Triassic Geological period, period, between 243 and 233.23 million years ago (mya), although the exact origin and timing of the #Evolutio ...

s. The bones occupied by sinuses vary with species.

Illustrations

File:Paranasal sinuses numbers.svg, Paranasal sinuses File:Blausen 0800 Sinusitis.png, Illustration depicting sinusitis

References

External links

{{Authority control Human head and neck Bones of the head and neck Rhinology Otorhinolaryngology