Endoscopic Anatomy of the Lateral Nasal Wall, Ostiomeatal Complex

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Endoscopic Anatomy of the Lateral Nasal
Wall, Ostiomeatal Complex Anterior Skull Base
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Reda KamelProfessor of RhinologyCairo
UniversityEgypt
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Anatomical Basis

• Common anatomy usual
• Anatomical variations
• Boundaries and limits

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Ostiomeatal complex OMC

• Anterior ethmoid middle meatus complex
• Bulla ethmoidalis
• Lamina papyracea
• Uncinate process
• Fovea ethmoidalis
• Basal lamella

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Ostiomeatal complex OMC
Suprabullar recess

Frontal ostium Lateral sinus
Frontal
recess Retrobullar recess
HSS
HSI


Maxillary ostium Infundibulum
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Ostiomeatal complex OMC

• Bulla ethmoidalis
• Hiatus semilunaris inferior
• Infundibulum
• Frontal recess Frontal ostium
• Maxillary ostium

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Ostiomeatal complex OMC

• Bulla ethmoidalis
• Hiatus semilunaris superior
• Lateral sinus
• Retro-bullar recess
• Supra-bullar recess

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Frontal recess
A
B
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Landmarks in FESS

• The four lamellae
• Uncinate process
• Bulla ethmoidalis
• Basal lamella
• Sphenoid sinus

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Uncinate process
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Skull base anterior ethmoids AEA

• Crista galli
• Septum
• Cribriform plate
• Middle turbinate
• Lateral lamella
• Fovea ethmoidalis

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Skull base anterior ethmoids
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Middle turbinate, basal lamella

• Part Site Direction Attachment
• 1st part (anterior) Vertical Skull
  base
• 2nd part (middle) Oblique Lamina
  papyracea
• 3rd part (posterior) Transverse
  Perpendicular plate
  
  of palatine bone

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Middle turbinate, basal lamella

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Basal lamella and ethmoids

• Basal lamella
• Anterior ethmoids
• Posterior ethmoids

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Sphenoid sinus

• Optic nerve
• Carotid artery
• Sella tursica
• Maxillary nerve
• Vidian nerve

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II- Anatomical Variations

• Concha bullosa
• Paradoxically bent middle turbinate
• Medially bent uncinate process
• Large bulla ethmoidalis
• Haller cell
• Sphenoethmoidal air cell

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III- Boundaries Limits

• Orbit
• Lamina papyracea
• Cranial cavity
• Fovea ethmoidalis
• Cribriform plate
• Sphenoid

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Endoscopic Sinonasal Surgery Conclusions

• Proper understanding of the anatomy of the
• Lateral nasal wall,
• Ostiomeatal complex
• Anterior skull base
• is mandatory to achieve
• Early and precise diagnosis of sinonasal lesions
• Safe and effective endoscopic sinonasal surgery

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