Changes in the Nasal Accessory Sinuses After Birth

Abstract

The antrums and ethnoids are the most fully developed of the nasal accessory sinuses of the full term fetus. At the time of birth, these sinuses are of appreciable size and fairly well surrounded by bony or cartilaginous structures. Later they contain air, and one usually thinks of them as cavities filled with air. However, in the unruptured amniotic sac these sinuses cannot contain air, and they only become aerated some time after birth. What then are the contents of the sinuses while in the unruptured amniotic sac, or during the period of birth before aeration has taken place? The time necessary for this clearing process to take place together with the physiologic phenomena involved constitutes a problem of rather unusual interest. The influence which variations of the physiologic phenomena may have on the subsequent health of the infant makes this study of considerable importance. The same problems apply to the middle ear and the mastoid, but at this time, I wish to consider only the ethmoids and the antrums.A rather careful survey of the literature reveals no information on such a study of the sinuses. Griffith and Mitchell1 stated that the middle ear contains no air at birth but only swollen mucous membrane and mucus, and von Reuss2 said that at birth the tympanic cavity contains only a yellow fluid and gelatinous tissue. But no reference could be found which dealt with these problems as they relate to the nasal accessory sinuses. There are several textbooks which give detailed descriptions of the anatomy of the sinuses. Schaeffer3 stated that "Even though the maxillary sinus is a cavity of considerable size in the newborn, often measuring 8 by 4 by 6 mm., it is not always demonstrable in skiagrams. This is probably due to the slit-like shape of the sinus,

CT characterization of developmental variations of the paranasal sinuses in cystic fibrosis

“…Pathogenesis of paranasal sinus development: The pathogenesis of abnormal paranasal sinus development is not exactly known, and the literature focusing on this theme is scarce. Chronic sinusitis in childhood has been the most frequently suggested explanation for sinus aplasia or hypoplasia (36, 53). Other factors which may contribute to reduced pneumatization are reduced O 2 ‐saturation and altered temperature (4), which may be secondary to chronic sinusitis or to sinonasal polyposis in young children, causing mouth breathing.…”

CT characterization of developmental variations of the paranasal sinuses in cystic fibrosis

“…Pathogenesis of paranasal sinus development: The pathogenesis of abnormal paranasal sinus development is not exactly known, and the literature focusing on this theme is scarce. Chronic sinusitis in childhood has been the most frequently suggested explanation for sinus aplasia or hypoplasia (36, 53). Other factors which may contribute to reduced pneumatization are reduced O 2 ‐saturation and altered temperature (4), which may be secondary to chronic sinusitis or to sinonasal polyposis in young children, causing mouth breathing.…”

Maxillary sinus hypoplasia

“…4 The reasons for maxillary sinus hypoplasia are poorly understood. Hall 6 has proposed intra-uterine developmental abnormalities and Wasson 7 has suggested sinus infection during the rst year of life as reasons for maxillary sinus hypoplasia.…”

Pediatric paranasal sinuses—Development, growth, pathology, & functional endoscopic sinus surgery

“…This prenatal fluid content allows magnetic resonance imaging detection of fetal maxillary sinuses from the 22nd gestational week (Ozcan et al, 2014). Early postnatal radiographs suggested that the MS becomes fully aerated between 1 and 6 months of life (Maresh & Washburn, 1940;Walter, 1933). More recent studies however have suggested that this occurs over a much wider time interval and that there are relatively high rates of maxillary sinus opacification even in healthy children, with one study showing approximately 50% of children less than 13 years old have some degree of sinus opacification (Diament et al, 1987;Glasier et al, 1989).…”

CT characterization of developmental variations of the paranasal sinuses in cystic fibrosis

“…Pathogenesis of paranasal sinus development: The pathogenesis of abnormal paranasal sinus development is not exactly known, and the literature focusing on this theme is scarce. Chronic sinusitis in childhood has been the most frequently suggested explanation for sinus aplasia or hypoplasia (36, 53). Other factors which may contribute to reduced pneumatization are reduced O 2 ‐saturation and altered temperature (4), which may be secondary to chronic sinusitis or to sinonasal polyposis in young children, causing mouth breathing.…”

Maxillary sinus hypoplasia

“…4 The reasons for maxillary sinus hypoplasia are poorly understood. Hall 6 has proposed intra-uterine developmental abnormalities and Wasson 7 has suggested sinus infection during the rst year of life as reasons for maxillary sinus hypoplasia.…”

Pediatric paranasal sinuses—Development, growth, pathology, & functional endoscopic sinus surgery

“…This prenatal fluid content allows magnetic resonance imaging detection of fetal maxillary sinuses from the 22nd gestational week (Ozcan et al, 2014). Early postnatal radiographs suggested that the MS becomes fully aerated between 1 and 6 months of life (Maresh & Washburn, 1940;Walter, 1933). More recent studies however have suggested that this occurs over a much wider time interval and that there are relatively high rates of maxillary sinus opacification even in healthy children, with one study showing approximately 50% of children less than 13 years old have some degree of sinus opacification (Diament et al, 1987;Glasier et al, 1989).…”

CT characterization of developmental variations of the paranasal sinuses in cystic fibrosis

“…Pathogenesis of paranasal sinus development: The pathogenesis of abnormal paranasal sinus development is not exactly known, and the literature focusing on this theme is scarce. Chronic sinusitis in childhood has been the most frequently suggested explanation for sinus aplasia or hypoplasia (36, 53). Other factors which may contribute to reduced pneumatization are reduced O 2 ‐saturation and altered temperature (4), which may be secondary to chronic sinusitis or to sinonasal polyposis in young children, causing mouth breathing.…”

Maxillary sinus hypoplasia

“…4 The reasons for maxillary sinus hypoplasia are poorly understood. Hall 6 has proposed intra-uterine developmental abnormalities and Wasson 7 has suggested sinus infection during the rst year of life as reasons for maxillary sinus hypoplasia.…”

Pediatric paranasal sinuses—Development, growth, pathology, & functional endoscopic sinus surgery

“…This prenatal fluid content allows magnetic resonance imaging detection of fetal maxillary sinuses from the 22nd gestational week (Ozcan et al, 2014). Early postnatal radiographs suggested that the MS becomes fully aerated between 1 and 6 months of life (Maresh & Washburn, 1940;Walter, 1933). More recent studies however have suggested that this occurs over a much wider time interval and that there are relatively high rates of maxillary sinus opacification even in healthy children, with one study showing approximately 50% of children less than 13 years old have some degree of sinus opacification (Diament et al, 1987;Glasier et al, 1989).…”