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APUNTES DE FISIOLOGA,
ANATOMA-RADIOLGICA-CLNICA
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las
New !
Updat
RADIOLOGICA ed
ANATOMA
CT SCAN
CORTES AXIALES, SAGITALES Y
RECONSTRUCCIN CORONAL..
REVISIN
DR. JUAN HERRERA SALAZAR
CLNICA DE ASMA Y ALERGIA
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88825513
84316459
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BIBLIOGRAFA
Atlas Netter II edicin.
Atlas Netter IV edicin Interactiva.
Atlas, Anatomy,Carmine de Clemente 3rd ed..
Gray s Anatomy
Emedecine collection
07/05/16
BIBLIOGRAFA EMEDECINE
Nasal Physiology Author: Sanford M Archer, MD; Chief
Editor: Arlen D Meyers, MD, MBA more...
Olfactory System Anatomy Author: Amir Vokshoor, MD;
Chief Editor: Arlen D Meyers, MD, MBA more...
Nasal Aerodynamics Author: Samuel J Lin, MD; Chief Editor:
Arlen D Meyers, MD, MBA more...
Nasal Reconstruction Author: Ali Sajjadian, MD, FACS; Chief
Editor: Arlen D Meyers, MD, MBA more...
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CT SCAN
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COMPLEJO OSTEOMEATAL
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SPHENOID SINUS
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This is a bony prominence that is often pneumatized in the ascending process of the maxilla. Its location below the frontal sinus also defines the
anterior limit of the frontal recess.
Concha bullosa:
The concha bullosa is a pneumatized middle turbinate. An enlarged middle turbinate may obstruct the middle meatus and the infundibulum
causing recurrent disease. It may also serve as a focal area of sinus disease.
Ethmoidal bulla:
This is the largest and most anterior ethmoid cell system. It is found posterior to the middle turbinate and posteromedial to the uncinate process.
Ethmoidal infundibulum: This is a space bordered medially by the uncinate process and laterally by the lamina papyracea. The maxillary sinus ostium is found inferiorly and laterally
within this space.
Haller cell (infraorbital cell): The Haller cell is usually situated below the orbit in the roof of the maxillary sinus. It is a pneumatized ethmoid cell that projects along the medial roof of
the maxillary sinus. Enlarged Haller cells may contribute to narrowing of the ethmoidal infundibulum and recurrent sinus disease, despite previous (incomplete) surgery.
Frontal recess: This is an hourglass-shaped space between the inferomedial aspect of the frontal sinus and the anterior middle meatus. Unfavorable variations of the structures that
define its borders may cause problems with the frontal sinus outflow tract. These structures include the agger nasi cell, supraorbital ethmoid cells, the ethmoid bulla, and inferiorly,
the uncinate process.
Lamina papyracea: This is a thin, bony wall separating the orbit from the ethmoid air cells. Dehiscences may occur for congenital reasons or because of previous surgery or facial
trauma.
Maxillary sinus ostium: This is the opening of the maxillary sinus to the nasal cavity and a part of the ostiomeatal complex.
Ostiomeatal complex or unit: This term refers to a collection of middle meatal structures and is not a discrete anatomic entity. It consists of the ethmoid infundibulum, anterior ethmoid
cells, and the uncinate process. It also represents the final common pathway of drainage for the frontal, maxillary, and anterior ethmoid cells. A patent ostiomeatal complex is
essential for the improvement of patients with sinus disease.
Paradoxical middle turbinate: The major curvature of the middle turbinate may project laterally, leading to narrowing of the middle meatus.
Sphenoethmoid cell (Onodi cell): This is formed by lateral and posterior pneumatization of the most posterior ethmoid cells over the sphenoid sinus. The presence of Onodi cells
increases the chance that the optic nerve and/or carotid artery would be exposed (or nearly exposed) in the pneumatized cell.
Uncinate process: This is a 3-dimensional sickle-shaped (also described as a hook- or L-shaped) bone of the lateral nasal wall. Anteriorly, the uncinate process attaches to the lacrimal
bone; inferiorly, the uncinate process attaches to the ethmoidal process of the inferior turbinate. The posterior edge lies in the hiatus semilunaris inferioris. Superiorly, the uncinate
process may attach to the middle turbinate, lamina papyracea, and/or the skull base.
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Ethmoidal infundibulum:
This is a space bordered medially by the uncinate process and laterally by the lamina
papyracea. The maxillary sinus ostium is found inferiorly and laterally within this space.
Frontal recess:
This is an hourglass-shaped space between the inferomedial aspect of the frontal
sinus and the anterior middle meatus. Unfavorable variations of the
structures that define its borders may cause problems with the frontal sinus
outflow tract. These structures include the agger nasi cell, supraorbital
ethmoid cells, the ethmoid bulla, and inferiorly, the uncinate process.
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Haller cell (infraorbital cell): The Haller cell is usually situated below the
orbit in the roof of the maxillary sinus. It is a pneumatized ethmoid cell
that projects along the medial roof of the maxillary sinus. Enlarged
Haller cells may contribute to narrowing of the ethmoidal infundibulum
and recurrent sinus disease, despite previous (incomplete) surgery.
Frontal recess: This is an hourglass-shaped space between the inferomedial
aspect of the frontal sinus and the anterior middle meatus. Unfavorable
variations of the structures that define its borders may cause problems
with the frontal sinus outflow tract. These structures include the agger
nasi cell, supraorbital ethmoid cells, the ethmoid bulla, and inferiorly,
the uncinate process.
Lamina papyracea: This is a thin, bony wall separating the orbit from the
ethmoid air cells. Dehiscences may occur for congenital reasons or
because of previous surgery or facial trauma.
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Maxillary sinus ostium: This is the opening of the maxillary sinus to the
nasal cavity and a part of the ostiomeatal complex.
Ostiomeatal complex or unit: This term refers to a collection of middle
meatal structures and is not a discrete anatomic entity. It consists of
the ethmoid infundibulum, anterior ethmoid cells, and the uncinate
process. It also represents the final common pathway of drainage
for the frontal, maxillary, and anterior ethmoid cells. A patent
ostiomeatal complex is essential for the improvement of patients
with sinus disease.
Paradoxical middle turbinate: The major curvature of the middle
turbinate may project laterally, leading to narrowing of the middle
meatus.
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PEARLS
In general, the larger the air cells, the thinner the bony walls become.
This may increase the chance for injuring structures within or
adjacent to such bony structures lining the air cell.
On CT scan, AFS is depicted as a heterogenous opacification that can
be seen with a typical pattern of central hyperdense areas of
opacification surrounded by less dense areas of opacification.
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ANATOMIA RADIOLGICA
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DEFINICIN DE SINUSITIS
Sinusitis is an inflammation of the mucosal lining of the
paranasal sinuses. As the mucosa of the sinuses is
continuous with that of the nose, rhinosinusitis is a more
suitable term.[1, 2]
Sinusitis can be subdivided into acute, subacute, and chronic
disease. Acute sinusitis is defined as disease lasting less
than 1 month. Subacute disease lasts 1-3 months, and
chronic sinusitis lasts longer than 3 months and is generally
related to suboptimally treated acute or subacute disease.
Acute and subacute sinusitis are treated medically, whereas
chronic sinusitis may require surgical intervention.
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CT provides an excellent
anatomic display of soft-tissue
attenuation. This depiction
includes fluid levels and polypoid
masses within the normally airfilled cavities of the sinuses,
nasal cavity, and postnasal
space. Most important, disease
extending beyond the bony
perimeters of the sinuses into
the adjacent soft tissue of the
orbit,[7]brain, and infratemporal
fossa can be imaged.
In general, nonenhanced CT
scans suffice in cases of
uncomplicated sinusitis.
Multisection CT seems to have
the potential to replace primary
coronal CT of the paranasal
sinuses without any loss of image
quality, and it may even improve
the overall diagnostic value.
However, the doses of radiation
may still have to be reduced.
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Si desean
ms
resolucin
hagn clik
inforadiologie.ch
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CT SCAN ANATOMA
Y FISIOLOGA
COM
Complejo Osteo
Meatal
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CT SCAN
ANATOMA Y
FISIOLOGA
Stammberger and
Messerklinger
Drainage
Complejo Osteo
Meatal Posterior
Normal
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Normal posterior
ostiomeatal complex.
The vomer separates
the two ostia into
the sphenoid sinus.
These ostia are
located in the
sphenoethmoid
recess. The vomer is
normally
pneumatized.
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CT SCAN
ANATOMA Y
FISIOLOGA
Complejo Osteo
Meatal Posterior
Normal
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A normal sagittal
reconstruction of
the OMC, showing
the curved edge
of the semilunar
hiatus with the
inferior mucosal
edge covering the
UP, can be seen in
the image below.
The frontal recess
is also shown.
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Bilateral
pneumatization of
the uncinate tips.
Expansion of the
tips can
compromise the
ethmoid
infundibulum, the
semilunar hiatus,
or the middle
meatus.
CT SCAN TEL. 22781169, 88825513 MOV, 84316459
CLARO
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Overexpansion
of the ethmoid
sinus floors
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Bilateral
ethmoid
sinusitis on an
MRI.
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COMPLEJO OSTEOMEATAL
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CT SCAN
Mucosal
thickening in
the left
anterior
ethmoid and
maxillary
sinuses and
in the region
of the
infundibulum.
This indicates
an
ostiomeatal
pattern of
TEL. 22781169, 88825513 MOV, 84316459
sinusitis CLARO
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CONCA BULOSA
Concha
bullosa of
the right
middle
turbinate.
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CELDAS DE HALLER
Paradoxical
curves of both
middle
turbinates
cause
narrowing of
the ostiomeatal
units.
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Magnetic Resona
nce Imaging
Sinusitis
Imaging
PARA LOS ESPECIALISTAS
Author: Rochita
Ultrasonography
V Ramanan,
MBBS, MD, DNB,
Nuclear Imaging
DMRD; Chief
Editor: L Gill
Angiography
Naul, MD
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CT scan
Spiral CT scan
1mm cuts
Magnetic Resonance
Imaging
The exclusive use of coronal CT scans for
sinus imaging could result in the failure
to diagnose nasal cavity neoplasms. In
the absence of bone destruction, an
esthesioneuroblastoma or other
neoplasm may be mistaken for a nasal
polyp on a CT scan, whereas on MRI, the
nature of this tumor is quite apparent.
Beyond anatomic variants, any
suspicious findings should be imaged by
means of MRI
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Gracias
!
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