Structure-function relationships in the nasal cavity of Arctic and subtropical seals.

The heating and moistening of inhaled air, and the cooling and moisture removal from exhaled air, are crucial for the survival of animals under severe environmental conditions. Arctic mammals have evolved specific adaptive mechanisms to retain warmth and water and restrict heat loss during breathing. Here, the role of the porous turbinates of the nasal cavities of Arctic and subtropical seals is studied with this in mind. Mass and energy balance equations are used to compute the time-dependent temperature and water vapor profiles along the nasal passage. A quasi-1D model based on computed tomography images of seal nasal cavities is used in numerical simulations. Measured cross-sectional areas of the air channel and the perimeters of the computed tomography slices along the nasal cavities of the two seal species are used. The model includes coupled heat and vapor transfer at the air-mucus interface and heat transfer at the interfaces between the tissues and blood vessels. The model, which assumes constant blood flow to the nose, can be used to predict the temperature of the exhaled air as a function of ambient temperature. The energy dissipation (entropy production) in the nasal passages was used to measure the relative importance of structural parameters for heat and water recovery. We found that an increase in perimeter led to significant decreases in the total energy dissipation. This is explained by improved conditions for heat and water transfer with a larger complexity of turbinates. Owing to differences in their nasal cavity morphology, the Arctic seal is expected to be advantaged in these respects relative to the subtropical seal.

Strategies of vascularization of the ethmoid labyrinth in selected even-toed ungulates (Artiodactyla) and carnivores (Carnivora).

The anatomy of the nasal cavity and its structures, as well as other elements building a scaffold for olfactory organs, differs significantly among various groups of mammals. Understanding anatomical conditions of quality of olfaction are being studied worldwide and is a complex problem. Among many studies regarding bone and epithelial structures of turbinates and connected anatomical structures, few studies describe the vascularization of turbinates. Ethmoid turbinates are above all covered in olfactory epithelium containing branched axons that receive olfactory stimuli and as olfactory nerves penetrate the cribriform lamina of the ethmoid bone conveying information from smell receptors to the brain. Differences in vascularization of the cribriform plate and turbinates may add crucial information complementing studies regarding the olfactory organ's bone and soft tissue structures. In the study, we describe the vascularization of the cribriform plate of the ethmoid bone of 54 Artiodactyla and Carnivora.

Nasosinusal Endoscopic Anatomy and Physiology

The present article focuses on the analysis of the nasal cavity's anatomy succinctly and descriptively. This essay was carried out through a bibliographic review, directed to the detailed anatomy of the nasal cavity, and the structures that form its sinuses. We have identified the need formore studies directed to the related anatomical area so that the improved knowledge of this region ensures a nasoendoscopic treatment with better effectiveness and no complications.

Evaluation of the Golden Ratio in Nasal Conchae for Surgical Anatomy.

PURPOSE: The golden ratio is reached by the fractal model of the number sequence which is known as the "Fibonacci series" and has a convergent ratio of approximately 1.618 between 2 consecutive Fibonacci numbers. Golden ratio relationships have been shown in several plants in the nature and several organs and structures in the human body. The conchae, which form an important part of the nasal valve, have a special geometric significant in terms of providing turbulence to the laminar airflow that passes to the nasal cavity. METHODS: This study made golden ratio calculations on 34 adults aged 20 to 45 years over computed tomography (CT) images. Totally, 34 volunteers (male, n = 18 and female, n = 16) with no nasal pathologies participated in the study. Using Adobe Photoshop, golden ratio calculations were made by applying the Fibonacci spiral on the images that best showed the conchae and meatuses on the CT images. RESULTS: The intersection points of the spiral that was projected on the inferior and middle nasal concha were determined as S0, S1, S2, S3, and S4. The distances of S0-S1, S1-S2, S2-S3, and S3-S4 were measured. The concha measurements of the women showed significantly similar values to the golden ratio constant of ∼1.618 in the RS3/S4 and LS3/S4 measurements. CONCLUSION: We found that the S3/S4 region that captured the golden ratio in our study corresponds to the base part of the inferior nasal concha, and its place of spiraling in the nasal cavity is observed to have an important role in creating vortices.

Morphometric differences in normal bony nasolacrimal anatomy: comparison between four ethnic groups.

PURPOSE: To compare bony nasolacrimal duct anatomy between ethnic groups. METHODS: A retrospective observational study of patients of four ethnic groups who had high-resolution CTs between 2004 and 2019 covering the full length of their nasolacrimal ducts in two hospitals in Essex, England. Only normal ducts were included; patients with tearing or radiological abnormalities were excluded. Measurements were taken of the nasolacrimal duct and surrounding anatomy based on measurements found in the existing literature. RESULTS: More females (n = 114) than males (n = 40) were included. South Asian (Indian subcontinent), Afro-Caribbean and European groups were equivocal demographically (n = 25-29, mean age 40-45); however, the Oriental group was fewer in number (n = 13) and slightly older (mean age 51). South Asian and European ducts had no significant differences. Afro-Caribbean ducts were wider and shorter than European. Afro-Caribbean faces are wider and their noses flatter and wider than European. Oriental ducts were wider and longer than European, but Europeans have taller noses. CONCLUSION: The results from our Oriental group fits with the published data in Orientals. The bony nasolacrimal duct is greater in calibre (inner diameter) if the patient is of Afro-Caribbean or Oriental origin compared to European or South Asian. Acquired nasolacrimal duct obstruction in Afro-Caribbean or Oriental patients may be more likely due to secondary causes.

Equine Nasal Endoscopy: Treating Bullae Disease and Sinus Disease.

The nasal conchal bullae (dorsal and ventral) are separate, air-filled structures within their respective dorsal and ventral nasal conchae. Computed tomography scans have assisted with the increasing diagnosis of empyema of the nasal conchae. This condition is usually associated with dental or sinus disease. Drainage of affected bullae is considered critical for resolution of clinical signs. The ventral conchal bullae can be easily viewed with a standard 10 mm diameter flexible endoscopy via the middle nasal meatus. This approach can also be used for fenestration of the bullae, using a diode laser, equine laryngeal forceps, or bipolar vessel sealing device.

Comparative growth in the olfactory system of the developing chick with considerations for evolutionary studies.

Despite the long-held assumption that olfaction plays a relatively minor role in the behavioral ecology of birds, crown-group avians exhibit marked phylogenetic variation in the size and form of the olfactory apparatus. As part of a larger effort to better understand the role of olfaction and olfactory tissues in the evolution and development of the avian skull, we present the first quantitative analysis of ontogenetic scaling between olfactory features [olfactory bulbs (OBs) and olfactory turbinates] and neighboring structures (cerebrum, total brain, respiratory turbinates) based on the model organism Gallus gallus. The OB develops under the predictions of a concerted evolutionary model with rapid early growth that is quickly overcome by the longer, sustained growth of the larger cerebrum. A similar pattern is found in the nasal cavity where the morphologically simple (non-scrolled) olfactory turbinates appear and mature early, with extended growth characterizing the larger and scrolled respiratory turbinates. Pairwise regressions largely recover allometric relationships among the examined structures, with a notable exception being the isometric trajectory of the OB and olfactory turbinate. Their parallel growth suggests a unique regulatory pathway that is likely driven by the morphogenesis of the olfactory nerve, which serves as a structural bridge between the two features. Still, isometry was not necessarily expected given that the olfactory epithelium covers more than just the turbinate. These data illuminate a number of evolutionary hypotheses that, moving forward, should inform tradeoffs and constraints between the olfactory and neighboring systems in the avian head.

Analysis of anatomical variation of the inclination of lamellas attached to the skull base and its correlation with the anterior ethmoidal artery floating in the ethmoid sinus for use in endoscopic sinus surgery.

PURPOSE: Attention to the inclination of lamellas attached to the skull base, including the basal lamella of the middle turbinate, facilitates the intraoperative identification of each lamella without requiring the use of a navigation system. We classified the inclination between the lamella and the skull base in preoperative computed tomography (CT) images and examined the relationship between the lamellas attached to the skull base, including the basal lamella of the middle turbinate, and the position of the anterior ethmoidal artery (AEA). We aimed to develop a preoperative classification to help prevent intraoperative injury of the AEA. METHODS: We retrospectively investigated the paranasal sinus sagittal section CT slices of 366 sides of 183 patients to assess the inclination of lamellas attached to the skull base and the AEA location. We also reviewed the AEA position, its correlation with the supraorbital ethmoid cell, and the lateral lamella of the cribriform plate. RESULTS: We classified the lamella inclination at the skull base as the anterior direction, perpendicular direction, and posterior direction types. Lamellas containing a floating AEA inclined in the anterior direction toward the skull base were observed in 68.9% of sides, inclination in the perpendicular direction was noted in 30.5% of sides, and inclination in the posterior direction was noted in 0.5% of sides. CONCLUSION: It is easier to identify the AEA intraoperatively when the lamella inclination of the skull base attachment is recognized based on preoperative CT findings. This approach could be applied to all paranasal sinus lamellas and assist in identifying the AEA and other nearby structures.

The sagittal grooves of the middle nasal turbinate determine paradoxical curvatures and bifidities.

BACKGROUND: Paradoxical curvature of the middle nasal turbinate (MT) is a common anatomic variant, usually found and reported on coronal CT slices. However, less attention has been paid to the sagittal groove (SG) which is determining it. AIM: The study aimed to determine paradoxical curvatures and bifidities in the sagittal groves of middle nasal turbinate. MATERIAL AND METHOD: A retrospective CBCT study on the archived files of 52 adult patients was performed. RESULTS: Different patterns of MT bifidity were found: (1) unilateral bifid MTs; (2) bifid and trifid MTs and "wandering" single SGs; (3) bilateral bifid middle turbinates and double SGs, (4) bilateral false bifid appearance due to middle and superior turbinates fusion and (5) bifid concha bullosa media. Digital "dissections" of patients' files allowed us to conclude that paradoxical curvature as well as bifidity of MTs relate to the placement and number of the SGs on the MTs. Such SGs were previously documented in prenatal MTs since the 14th week, as well as in pædiatric patients. CONCLUSIONS: It seems reasonable to speculate that paradoxical curvature, as well as bifidity of MT, this later being previously undocumented, are just adult vestiges of the primitive MT morphology. Nevertheless, documentation of the MT morphology should not rely exclusively on coronal CTs, as combined morphologies of that turbinate could occur.

Convergent evolution of olfactory and thermoregulatory capacities in small amphibious mammals.

Olfaction and thermoregulation are key functions for mammals. The former is critical to feeding, mating, and predator avoidance behaviors, while the latter is essential for homeothermy. Aquatic and amphibious mammals face olfactory and thermoregulatory challenges not generally encountered by terrestrial species. In mammals, the nasal cavity houses a bony system supporting soft tissues and sensory organs implicated in either olfactory or thermoregulatory functions. It is hypothesized that to cope with aquatic environments, amphibious mammals have expanded their thermoregulatory capacity at the expense of their olfactory system. We investigated the evolutionary history of this potential trade-off using a comparative dataset of three-dimensional (3D) CT scans of 189 skulls, capturing 17 independent transitions from a strictly terrestrial to an amphibious lifestyle across small mammals (Afrosoricida, Eulipotyphla, and Rodentia). We identified rapid and repeated loss of olfactory capacities synchronously associated with gains in thermoregulatory capacity in amphibious taxa sampled from across mammalian phylogenetic diversity. Evolutionary models further reveal that these convergences result from faster rates of turbinal bone evolution and release of selective constraints on the thermoregulatory-olfaction trade-off in amphibious species. Lastly, we demonstrated that traits related to vital functions evolved faster to the optimum compared to traits that are not related to vital functions.

Nasal cavities and the nasal septum: Anatomical variants and assessment of features with computed tomography.

The nasal cavities are complex anatomical structures with high inter-individual variability that relates to different functions. Different anatomic variants may manifest at this site, mainly belonging to the nasal septum and turbinates. Precise knowledge of the anatomy and variants is fundamental for both radiologists and ENT surgeons. This article provides an overview of the main anatomic variants and their frequency, according to the existing literature, as well as ongoing research on nasal cavity segmentation in order to obtain personal 3D models and to predict post-surgical results.

Vascular Anatomy of the Inferior Turbinate and Its Clinical Implications.

BACKGROUND: Published reports on the vascular anatomy of the inferior turbinate (IT) are limited. Historical papers report the IT artery as a tributary off the posterior lateral nasal artery (PLNA), but this has not been our clinical experience. OBJECTIVE: The purpose of this study was to examine the arterial blood supply to and the branching pattern within the IT. We discuss this is the context of IT surgery and relate it to postoperative bleeding complication rates. METHODS: Endoscopic dissection was performed on 16 cadaver heads (24 sides) to determine the origin of the IT artery. Intraoperative surgical videos were analyzed in 50 patients to uncover the vascular branching pattern within the IT. A retrospective review of bleeding complications in patients undergoing IT reduction surgery was also conducted. RESULTS: In 17 of 24 sides (70.8%), the IT artery arose either exclusively (54.2%) or partly (16.6%) off the descending palatine artery (DPA). As a branch off the DPA, the IT artery exited the pterygopalatine fossa through a foramen located 7.7 ± 3.0 mm from posterior edge of the IT, 8.4 ± 3.1 mm above the nasal floor and 1.6 ± 2.1 mm below the insertion of the IT bone onto the lateral nasal wall. The mean number of arteries cascading within the IT was 2.7 ± 0.5. Moreover, 112 patients underwent IT reduction surgery and 2 (1.8%) experienced postoperative epistaxis. CONCLUSION: The IT artery has major contributions from the DPA. Most commonly 3 arteries branch within the IT. Knowledge of this vascular anatomy may minimize bleeding associated with IT reduction surgery.

Reduction of olfactory and respiratory turbinates in the transition of whales from land to sea: the semiaquatic middle Eocene Aegyptocetus tarfa.

Ethmoturbinates, nasoturbinates, and maxilloturbinates are well developed in the narial tract of land-dwelling artiodactyls ancestral to whales, but these are greatly reduced or lost entirely in modern whales. Aegyptocetus tarfa is a semiaquatic protocetid from the middle Eocene of Egypt. Computed axial tomography scans of the skull show that A. tarfa retained all three sets of turbinates like a land mammal. It is intermediate between terrestrial artiodactyls and aquatic whales in reduction of the turbinates. Ethmoturbinates in A. tarfa have 26% of the surface area expected for an artiodactyl. These have an olfactory function and indicate that early whales retained a sense of smell in the transition from land to sea. Maxilloturbinates in A. tarfa have 6% of the surface area expected for an artiodactyl. These have a respiratory function and their markedly reduced size suggests that rapid inhalation and exhalation was already more important than warming and humidifying air, in contrast to extant land mammals. Finally, the maxilloturbinates of A. tarfa, although greatly reduced, still show some degree of similarity to those of artiodactyls, supporting the phylogenetic affinity of cetaceans and artiodactyls based on morphological and molecular evidence.

Safety and efficacy of superior turbinate biopsies as a source of olfactory epithelium appropriate for morphological analysis.

PURPOSE: There is no standardized approach for preserving olfactory function in the side of the nose where biopsy of the olfactory epithelium (OE) is performed. Moreover, a gold standard technique for obtaining human OE in vivo is still lacking. We determined the efficacy of obtaining good-quality OE specimens suitable for pathological analysis from the lower half of the superior turbinate and verified the safety of this procedure in maintaining bilateral and unilateral olfactory function. METHODS: In 21 individuals without olfactory complaints and who had undergone septoplasty and inferior turbinectomy OE biopsy was made during septoplasty. Olfactory function, both unilateral and bilateral, was assessed using the University of Pennsylvania Smell Identification Test (UPSIT) before and 1 month after the procedure. Specimens were marked with the olfactory marker protein for confirmation of OE presence. RESULTS: Ninety percent of the samples contained OE, although clear histological characterization was possible from only 62%. There was no deterioration of UPSIT scores either bilaterally or unilaterally on the side of the biopsy. Patients also maintained the ability to identify individual odorants. CONCLUSION: Biopsies of the lower half of the superior turbinate do not affect olfactory function and show strong efficacy in yielding OE tissue and moderate efficacy for yielding tissue appropriate for morphological analysis. Future studies are needed to assess the safety of this procedure in other OE regions.

Extraoral anatomy in CBCT ­ a literature review. Part 1: Nasoethmoidal region

Cone beam computed tomography has become a widely used imaging technique for dental indications. Depending on the selected size of the field of view, anatomical structures outside the dentomaxillary complex become visible. As a consequence, the clinician must be able to interpret also those anatomical regions. In this article, the anatomy of the nasoethmoidal region is presented based on a literature review. The nose is characterized by the nasal septum and the superior, middle, and inferior conchae. The turbinates may be pneumatized (concha bullosa), mainly the middle concha. The ethmoid bone has a complex morphology (ethmoid labyrinths) and contributes with its perpendicular plate to the nasal septum. Other structures of the septum include the vomer and the septal cartilage. The nasal meatuses stabilize the airflow and direct the inhaled air to the nasopharynx via the choanae. The middle nasal meatus, which is also a part of the so called ostiomeatal complex, serves as the major drainage area (semilunar hiatus) of the paranasal sinuses, i.e., maxillary sinus, anterior ethmoid cells, and frontal sinus. Posterior ethmoid cells empty into the superior meatus and the sphenoid sinus drains into the sphenoethmoidal recess, located above the superior concha. The nasolacrimal duct that is running along the middle portion of the lateral nasal wall opens into the inferior nasal meatus.

Anatomic variations associated with antrochoanal polyps.

OBJECTIVE: Although more than a century has passed since antrochoanal polyps (ACPs) were first defined, etiopathogenesis still remains unclear. The aim of this study was to investigate the relationship between ACPs and sinonasal cavity variations. SUBJECTS AND METHODS: One hundred and forty-four patients with ACP on paranasal sinus computed tomography scans (ACP group) and 160 paranasal sinuses without ACP (control group) were included into the study. The study group was evaluated in respect of the presence of retention cyst in the contralateral maxillary sinus and sinus bone wall sclerosis thickening. Both groups were also compared with respect to the frequency of sinonasal anatomic variations, nasal septal deviation, variations of the uncinate process insertion, concha bullosa, paradoxical middle turbinate, and accessory maxillary sinus ostium. In the ACP group, the cases with septal deviation (SD) were also evaluated whether the deviation convexity was towards the polyp side or the opposite side. In addition, the posterior extension of ACPs were evaluated in three groups as middle meatus, nasopharynx, and oropharynx extension. RESULTS: The prevalence of retention cyst, sinus wall sclerosis thickening, SD, and accessory maxillary ostium was significantly higher in the ACP group. A negative directional correlation was determined between the SD side and ACP side. When the ACP extensions were examined, middle meatus extension was seen in 32.6%, nasopharynx in 56.3%, and oropharynx in 11.1%. CONCLUSION: Accessory ostium may be an accelerating factor in the transformation of retention cyst to ACP. Furthermore, the changes in the nasal passage airflow on the opposite side suggest that SD contributes to this process.

Anatomical considerations in endoscopic lacrimal surgery.

PURPOSE: To provide a review of the anatomy of the lacrimal drainage system and lateral wall of the nose pertaining to endoscopic dacryocystorhinostomy. METHODS: The authors performed a PubMed search of articles published pertaining to the anatomy of the lateral wall of the nose and the anatomy of endonasal and external dacryocystorhinostomy surgery. RESULTS: The article covers the regional surface and surgical anatomy for endoscopic dacryocystorhinostomy (DCR), including the maxillary line, middle turbinate, agger nasi air cell, lacrimal sac and fossa and the upper portion of the nasolacrimal drainage system. It also explores the dimensions and location of bony ostium formation to ensure full exposure and marsupialisation of the lacrimal sac. Finally, it covers the anatomy of potential complications of endoscopic DCR surgery including penetration of the skull base and orbit, inadvertent entry to the maxillary sinus and breach of the skin. CONCLUSION: A good understanding of the anatomy of the lacrimal drainage system and the lateral wall of the nose will increase the likelihood of successful surgery and minimize the risk of complications and damage to neighbouring structures such as the orbit and skull base.

Climatic adaptation in human inferior nasal turbinate morphology: Evidence from Arctic and equatorial populations.

OBJECTIVES: The nasal turbinates directly influence the overall size, shape, and surface area of the nasal passages, and thus contribute to intranasal heat and moisture exchange. However, unlike the encapsulating walls of the nasal cavity, ecogeographic variation in nasal turbinate morphology among humans has not yet been established. Here we investigate variation in inferior nasal turbinate morphology in two populations from climatically extreme environments. MATERIALS AND METHODS: Twenty-three linear measurements of the inferior turbinate, nasal cavity walls, and airway passages were collected from CT scans of indigenous modern human crania from Equatorial Africa (n = 35) and the Arctic Circle (n = 35). MANOVA and ANCOVA were employed to test for predicted regional and sex differences in morphology between the samples. RESULTS: Significant morphological differences were identified between the two regional samples, with no evidence of significant sexual dimorphism or region-sex interaction effect. Individuals from the Arctic Circle possessed superoinferiorly and mediolaterally larger inferior turbinates compared to Equatorial Africans. In conjunction with the surrounding nasal cavity walls, these differences in turbinate morphology produced airway dimensions that were both consistent with functional expectations and more regionally distinct than either skeletal component independently. CONCLUSION: This study documents the existence of ecogeographic variation in human nasal turbinate morphology reflecting climate-mediated evolutionary demands on intranasal heat and moisture exchange. Humans adapted to cold-dry environments exhibit turbinate morphologies that enhance contact between respired air and nasal mucosa to facilitate respiratory air conditioning. Conversely, humans adapted to hot-humid environments exhibit turbinate morphologies that minimize air-to-mucosa contact, likely to minimize airflow resistance and/or facilitate expiratory heat-shedding.