Ethmoid anatomy

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The ethmoid bone is a cubic bone located in the center of the skull between the eyes. It helps to form the walls of the orbit or orbital cavity, as well as the roof, sides, and interior of the nasal cavity.

Very light and spongy in texture, the ethmoid bone is one of the most difficult bones in the face.

Anatomy

The ethmoid bone has four main parts. Lattice mazes consist of two hollow bone blocks. Ethmoid labyrinths are made up of many thin-walled compartments known as ethmoid (air) cells. With age, the number of cells increases.

At birth, it will only have three to four cells on the trellis; however, as an adult, you will normally be between 10 and 15.

These ethmoid cells form what are more commonly known as ethmoid sinuses . The ethmoid cavities are one of the four pairs of sinus cavities on your face, the rest are maxillary, frontal and sphenoid sinus cavities.

The outer edges of the lattice mazes are called papyrus plate or orbital plate . The papyrus plate makes up most of the inner wall of the orbital cavity and connects to the frontal bone, palatine bone, lacrimal bone, and sphenoid bone.

In the center of the ethmoid bone between the ethmoid labyrinth there is a perpendicular plate , which forms the upper part of the bony septum of the nose; the lower part of the nasal septum is made up of the vomer and the palatine bone.

The inner edges of the lattice mazes are connected by a lattice plate , which is also connected to the perpendicular plate. The ethmoid plate is important because it is part of the base of the skull.

Above these structures, you also have the crista galli , which attaches to the piece of connective tissue that surrounds your brain, holding it in place.

The superior and middle turbinates , also known as turbinates, extend from the inner edge of the ethmoid labyrinth. The shells help increase the surface area of your nasal passages, helping to warm, hydrate, and purify the air you breathe.

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Function

Since the ethmoid bone is in the middle of the face, it supports many daily activities. The lattice plate has sieve holes that allow the olfactory nerves to be placed in the nose so it can smell and also play a role in its ability to taste.

The sinus cavities in the ethmoid labyrinth serve many important functions, including:

  • Production of mucus to trap allergens or other particles that can be harmful if inhaled through the nose.
  • Vocal tone
  • Reduce head weight

The turbinates, which form the lattice turbines, allow air to circulate and become moist as it travels from the nose to the lungs. The mucus that forms in the nasal cavities lines this part of the nose, which also serves as a defense mechanism, trapping any particles that may cause disease or other reactions.

The arteries to the nose also pass through various channels in the ethmoid bone, which serve to protect these arteries from injury.

Related conditions

The ethmoid bone, due to its central location in the face, is prone to fractures. However, because there are other bones around it, the ethmoid bone rarely breaks on its own.

In the case of a fracture, it is usually part of a complex NOE (nasoorbitoethmoid) fracture . This type of fracture is usually the result of blunt trauma, such as a car accident or a contact sports injury.

Because the nasal , orbital, and ethmoid bones are highly vascular, meaning that there are many blood vessels in this area, heavy nosebleeds (epistaxis) usually occur with a NOE fracture.

Other symptoms associated with a NOE fracture include:

  • Epiphora (overflow of tears)
  • Diplopia (double vision)
  • Enophthalmos (displacement of the eyeball
  • Telecanthus (greater distance between the inner corners of the eyes)
  • "Raccoon eyes" (bruises around the entire eye)

When you visit your doctor for a sinus test, they may never tell you which sinuses are inflamed or infected. However, the type of symptoms you are experiencing may indicate which sinus cavity is causing you discomfort.

Common symptoms of ethmoid sinusitis include pain behind and between the eyes and on the sides of the nose, swelling of the eyelids, and loss of smell (olfactory dysfunction).

A curved septum can include a part of a perpendicular plate. Depending on the severity of your case, you may not notice any symptoms. However, more severe cases can cause nosebleeds and difficulty breathing through one nostril.

Ethmoid cancer is very rare and is generally classified as a malignant neoplasm of the nose. The prevalence is low compared to the more common sinus or maxillary malignancies.

As with all cancers, early detection improves survival. If ethmoid cancer remains localized, 82 out of 100 people are alive after five years. However, if ethmoid cancer has metastasized or spread to other parts of the body, only 43 to 52 out of 100 people will live longer than five years.

Watch out

If you have an injury to your face and develop symptoms of a NOE fracture, you should seek immediate medical attention. Rapid diagnosis of a NOE fracture with careful evaluation to determine if surgery is necessary is essential for optimal recovery.

Most sinus infections are caused by a virus. therefore, antibiotics are generally not recommended. If you have a weakened immune system, you have a higher risk of getting a bacterial or fungal sinus infection.

However, based on the following criteria, your healthcare provider may prescribe an antibiotic, probably amoxicillin / clavulanate, even without a positive culture:

  1. You have mild to moderate symptoms that last 10 days or more.
  2. You have severe symptoms, such as a fever or severe pain, that last for at least three days.
  3. Your symptoms get worse after you start to get better (this is called "double disease").

If your healthcare provider is concerned that polyps are the main cause of your symptoms, they will most likely schedule you for a computed tomography (CT) scan.

Your healthcare provider can also use a fiber optic oscilloscope to view the inside of your nose and nasal cavities. Treatment of polyps in the ethmoid sinuses or correction of a deviated septum can be done surgically.

Proper diagnosis and treatment of ethmoid / sinus cancer or other types of sinus cancer requires the involvement of multiple healthcare providers. Your interdisciplinary team may include:

  • Otolaryngologist (otolaryngologist)
  • Neurosurgeon
  • Radiologist Oncologist
  • Oncologist doctor

If the tumor is small and / or benign, the surgeon may perform an external ethmoidectomy. For this operation, you can expect a small incision in the upper part of the nose, near the upper eyelid. By removing a small piece of bone that is part of your orbital bones, your surgeon can remove the tumor.

If the tumor has spread to the ethmoid sinus cavity, skull base, or brain, your surgical team will include both an otolaryngologist and neurosurgeon due to the junctional tissue of the ethmoid crista galli that surrounds the brain and the risk of neurological diseases. problems when complications. This operation is called a craniofacial resection.

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