RHINOLOGY: MALFORMATIONS, FOREIGN BODIES AND EPISTAXIS OTORHINOLARINGOLOGY SECTION ORAL MANIFESTATIONS OF SYSTEMIC DISEASES 2nd year of Dentistry 2024/2025 Dr Ana Checa-Ros Department of Medicine & Surgery

External part of nose

Internal nasal cavity

Communicates posteriorly with nasopharynx by two apertures called chonae

Communicates posteriorly with middle ear through Eustachian tube

Meatus

The inferior, superior and middle nasal conchae (turbinates) attach to the lateral wall and project to the cavity.

Inferior nasal meatus: between the floor and the inferior
concha
• Middle nasal meatus: between the inferior and middle
concha
• Superior nasal meatus: between the middle and superior
concha

Blood supply

External carotid artery gives branches to supply the nasal cavity. The internal carotid artery gives branches to the external part of the nose. These branches anastomose at kiesselbachs area, where epistaxis occurs.

Nerve supply

Olfactory nerve (CN 1)- Provides olfaction

Trigeminal Nerve (CN 5)- Conveys general sensation

Paranasal sinuses

Several functions

Air humidification
• Increase of voice resonance
• Trapping microbes in the inspired air
• Protection of internal structures

Four paranasal sinuses-

Frontal sinuses

Sphnoidal sinuses

ethmoidal sinuses

maxillary sinuses

Maxillary sinus

Superior to root of maxillary teeth, located under the orbit and has the nasal cavity lateral. Largest sinus.

Frontal sinus

Sup[erior one, above the eyebrow

Sphenoidal sinus

Bellow stella turchina

Ethmoidal Sinus

Located on ethmoidal bone. connected to orbital area so infection may be spread between them.

Arhinia

Congenital absence is nose.

Treatment is surgically created nasal airway or tracheostomy tube.

Unilateral Arhinia or Heminasal Aplasia

Unilateral absence of one nostril, reconstructive operation is needed.

Polyrhinia

Partial or complete duplication of nose

Choanal atresia

Obstruction of one or both chosen, chracterised by respiratory distress at birth, treatment is surgical.

Choanal atresia is a common finding of the CHARGE Syndrome:
• C=coloboma (eye malformation)
• H=heart defects
• A=atresia of the choanae
• R=retarded growth
• G=genitourinary abnormalities
• E=ear anomalies