Sinuswege

Sinuswege are the anatomical drainage pathways of the paranasal sinuses, i.e., the routes by which mucus and air pass from the sinus cavities into the nasal cavity or adjacent spaces. The sinuses communicate with the nasal cavity through natural openings called ostia, and the patency of these routes is essential for sinus ventilation and drainage. In medical literature, the concept is often described as the ostiomeatal complex and related drainage channels.

The major sinus drainage pathways include:

- Frontal sinus: drains via the frontonasal duct into the middle meatus, typically through the frontal recess and infundibulum.

- Maxillary sinus: drains through the maxillary ostium into the middle meatus, within the ostiomeatal complex.

- Ethmoid sinuses: anterior and middle ethmoid cells drain into the middle meatus through multiple ostia; posterior ethmoid cells drain into the superior meatus.

- Sphenoid sinus: drains into the sphenoethmoidal recess, located above the superior meatus.

Clinical relevance: Obstruction or inflammation of these routes can impair drainage and ventilation, contributing to acute or chronic sinusitis. Anatomical variants, such as concha bullosa, agger nasi cells, or oversized Haller cells, can alter drainage patterns and predispose to blockage.

Diagnosis and treatment: Evaluation typically involves nasal endoscopy and computed tomography to map Ostia and drainage pathways. Medical management aims to reduce mucosal swelling and secretions. When conservative therapy fails, endoscopic sinus surgery may widen the ostia and restore unobstructed drainage, addressing the underlying sinus pathways.