There have been a number of recent findings on the paranasal sinuses.  Groups have been trying to determine the function of the sinuses.  Some of this information is presented below.

The sinuses contribute to nasal humidification.  Nasal humdification has been shown to contribute as much as 6.9mmHg on serum pO2.  Although the nasal mucosa is best adapted to perform this task, the sinuses have been shown to contribute to warming and humidication.  This suggests that the paranasal sinuses are contributary to the concentration of oxygen within the blood.

The most recent research on sinus function has focused on Nitric Oxide (NO). High concentrations of nitric oxide in the nasal cavity and paranasal sinuses have important implications.  In healthly subjects, a large part of the exhaled NO appears to originate from the paranasal sinuses.  NO provides a first line defense against micro-organisms through its antiviral and antibacterial activity and via the upregulation of ciliary motility that NO produces.  Nasal treatments such as polypectomy, removal of hypertrophic adenoids and tonsils and treatments of allergic rhinitis may alter NO output and therefore microbial colonisation of the upper airways.  Nasal surgery aimed at relieving nasal obstruction may do the same but would be expected to improve pulmonary function in patients with asthma and upper airway obstruction.  Concentrations of nitric oxide are reduced in sinusitis.

A recent study (Jens et al 2000) reported on the endogenous production of carbon monoxide (CO) in human nose and paranasal sinues.  CO appears to be involved in both upper and lower airway inflammation.  Research showed the rate limiting enzyme for CO production, haem-oxygenase, like activity in the respiratory epithelium, and connected to the sero-mucinous glands and vascular smooth muscle of the nose.  Sampling through a drainage tube inserted in the maxillary sinus revealed levels of CO comparable to levels obtained by sampling through the nose.  They concluded that the nose and paranasal sinuses contribute to  CO production in the human airway.

Much research exists on the surgical anatomy of the paranasal sinuses.  This is prescribed to avoid complications during surgery.  Perez-Pinas et al (2000) have studied anatomical variation within the paranasal sinuses, including agger nasi cells and concha bullosa.  Knowledge of the potential sites of anatomical variations is essential to the proper practice of FESS.

Research is continuing into the functional and clinical anatomy of the paranasal sinuses.  These cavities are not well understood and will probably prove to have numerous complex functions.  Given that they are the source of infection, allergy and tumour, important causes of morbidity and mortality, this research is justified.

Other sources of information on the paranasal sinuses

Available in the University Library

• Ballenger and Snow Jr. (1991).  Otorhinolaryngology: Head and Neck Surgery.  Fifteenth edition.  Williams and Wilkins.
• Sinnatamby (2000).  Last's Anatomy: Regional and Applied.  Tenth edition.  Churchill Livingstone.
• Romanes (2000).  Cunnigham's Manual of Practical Anatomy: Volume Three; Head and Neck and Brain.  Fifteenth edition.  Oxford Medical Publications.
• Stamberger (1991).  Imaging of the Paranasal Sinuses.  First edition.

• Hoseman W (1998).  HNO 46 (12): 1003.  Local Anaesthesia in FESS.
• Paulsson B et al (2002).  Ann Otorhinolarygnology 111 (8): 710-7.  133-Xenon washout as an objective measure of paranasal sinus ventilation in ESS.
• Bargouth G et al (2002).    European Radiology 12 (6): 1451-8.  Size of the paranasal sinuses in children by MRI and volume measurement by percentile curves.
• Ramadan HH (2002).  Ann J Rhinology 16 (1): 61-7.  Intranasal innoculation of reovirus in mice - the role of the immune system in sinusitis.
• Timmenga N et al (2002).  Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontics 93 (1): 103-9.  Waters view: the value for assessing maxillary sinus inflammatory disease.
• Parnes SM 2002).  Expert Opinion in Pharmacotherapy 3 (1): 33-8.  Role of Leukotrienes in the Paranasal Sinuses (Review).
• Rasmalichov S et al (2001).  Khiringier 57 (34): 65.  Primary melanoma of the paranasal sinus mucosa (Review).
• Wani MK et al (2001).  Journal of Otolaryngology 30 (5): 257-62.  MRI of the paranasal sinuses: Incidental abnormalities and their relationship to patient symptoms.
• Anderson TD (2001).  Current Allergy and Asthmatic Reports 1 (3) 282-8.  Surgical intervention for sinusitis in adults.
• Jones NS (2002).  Clinical Otolaryngology and Allied Sciences 27 (1) 11-7.  CT of the paranasal sinuses: A review of the correlation with clinical, surgical, histopathological findings.

• www.med.edu.umich.edu
• www.vesalius.com
• www.ohsu.edu/cliniweb/C8/C8.460.692
• www.cancer.gov/templates/
• www.upci.upmc.edu/internet/headneck/ cancer/paranasal/
• www.xray2000.f9.co.uk/site3/technique/skull/facillat.htm
• www.anatome.ncl.ac.uk/tutorials/skulleasy/text/pg4.html

The Hunterian Museum or Head and Neck Dissections available in the Practical Sessions.

Dissection sessions for the Head and Neck course will allow you to visualise these structures first hand.