TY  - CHAP
M1  - Book, Section
TI  - Sinonasal Development and Anatomy
A1  - Blaichman, Jason I.
A2  - Chan, Yvonne
A2  - Goddard, John C.
PY  - 2019
T2  - K.J. Lee’s Essential Otolaryngology: Head and Neck Surgery, 12e
AB  - Nasal  embryologyThe  embryologic  precursors  of  the  nasal  turbinates  arise  in  the  eighth  week  of  gestation  as  ridges  along  the  lateral  nasal  wall.Maxilloturbinal:  originates  inferiorly  from  the  maxillary  process  and  gives  rise  to  inferior  turbinate.Ethmoturbinals:  arise  superiorly  from  ethmoid  bone,  five  arise  with  only  four  persisting  throughout  development.First  ethmoturbinal:Ascending  portion  gives  rise  to  agger  nasiDescending  portion  gives  rise  to  uncinate  process  (UP)Regresses  during  developmentSecond  ethmoturbinal:  gives  rise  to  middle  turbinateThird  ethmoturbinal:  gives  rise  to  superior  turbinateFourth  and  fifth  ethmoturbinals:  gives  rise  to  supreme  turbinate  (when  present)Primary  furrows:  form  the  recesses  separating  the  ethmoturbinals  and  gives  rise  to  meatiFirst  primary  furrow:  separates  first  and  second  ethmoturbinals;  gives  rise  to  middle  meatusSecond  primary  furrow:  gives  rise  to  superior  meatusThird  primary  furrow:  gives  rise  to  supreme  meatusExternal  nasal  anatomySubcutaneous  layers  of  the  noseMnemonic  =  “Subcutaneous  Fat  DeePS  =  Superficial  fatty  layer  (connected  to  dermis)F  =  Fibromuscular  layer  (nasal  superficial  musculoaponeurotic  system  [SMAS])D  =  Deep  fatty  layers  (contains  neurovascular  system)P  =  Periosteum/perichondriumOptimal  plane  of  dissection  is  located  between  D  and  P  as  it  is  avascular  and  heals  with  minimal  fibrosisExternal  nasal  landmarksNasion:  corresponds  to  nasofrontal  sutureRadix:  nasal  root;  centered  at  nasion,  extends  inferiorly  to  the  level  of  the  lateral  canthus  and  superiorly  by  equivalent  distanceRhinion:  corresponds  to  bony-cartilaginous  junction  along  nasal  dorsumSupratip  break:  a  break  in  the  nasal  profile  separating  the  nasal  dorsum  and  lobule  located  immediately  superior  to  the  tip  defining  pointSupratip  lobule:  portion  of  lobule  located  superior  to  tip-defining  pointTip  defining  point:  two  points  located  at  the  highest,  medial,  and  cephalic  portion  of  the  lateral  crus;  corresponds  to  light  reflex  externallyInfratip  lobule:  portion  of  lobule  located  inferior  to  tip-defining  point  and  superior  to  infratip  breakInfratip  break:  lobule-columella  junctionNasal  sill:  nostril  rim  located  between  columella  and  alar  facial  attachmentNasal  tip  supportMajor  tip  supportsMedial  and  lateral  cruraAttachment  of  medial  crura  to  caudal  edge  of  quadrangular  cartilageAttachment  of  upper  lateral  cartilage  to  lower  lateral  cartilage  (“scroll  area”)Minor  tip  supportsSkin-soft  tissue  envelope  (attachment  of  lower  lateral  cartilage  to  overlying  skin  and  musculature)Sesamoid  complex  (located  between  lateral  crura  and  pyriform  aperture)Interdomal  ligament  (located  between  lower  lateral  cartilages)Anterior  nasal  spineCartilaginous  septal  dorsumMembranous  nasal  septumNasal  osteologyTwo  nasal  bones  fuse  in  the  midline  to  form  a  pyramidal  shapeNasal  bones  are  thicker  superiorly  than  inferiorlyNasal  bone  attachments  =Superior:  nasal  process  of  frontal  boneLateral:  frontal  process  of  maxillaPyriform  aperture  =  bony  opening  into  the  nasal  cavity  bounded  bySuperior:  caudal  margin  of  nasal  bonesInferior:  alveolar  process  of  maxillaLateral:  frontal  process  of  maxillaMedial:  nasal  septumNasal  cartilagesUpper  lateral  cartilage  (ULC)Attached  superiorly  to  nasal  bonesArticulates  inferiorly  with  the  cephalic  margin  of  the  LLC  most  often  forming  an  interlocking  scrollThickens  medially  where  it  becomes  continuous  with  the  quadrangular  cartilage  of  the  septum  forming  the  cartilaginous  portion  of  the  nasal  dorsumLower  lateral  cartilage  (LLC)Provides  the  shape  of  the  nasal  tipComposed  of  medial  and  lateral  cruraSesamoid  cartilagesSmall  cartilages  located  lateral  to  the  lateral  crusNasal  septumComprised  of  both  bony  and  cartilaginous  components,  lined  by  either  a  mucoperiosteal  or  mucoperichondrial  layerCartilage  =  quadrangular  cartilageBone  =  perpendicular  plate  of  ethmoid,  vomer,  crest  of  the  maxillary  bone,  crest  of  the  palatine  bone;  minor  contributions  from  crest  ...
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/18
UR  - accesssurgery.mhmedical.com/content.aspx?aid=1172370227
ER  -