Rhinology diagrams for pg exam according to standard ENT textbook

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I now have an excellent collection of high-quality rhinology diagrams from Scott-Brown's and KJ Lee's. Let me compile the comprehensive answer with all diagrams.

Rhinology Diagrams for PG Exam - Standard ENT Textbooks

Sources: Scott-Brown's Otorhinolaryngology Head & Neck Surgery (Vol 1) and K.J. Lee's Essential Otolaryngology

1. Embryological Development of the Nose

Embryological development of the primitive nose - frontonasal process, medial and lateral nasal folds, maxillary process, and Rathke's pouch

Figure 87.1 - Embryological development of the primitive nose and palate. Key structures: frontonasal process, medial and lateral nasal folds, maxillary process, and Rathke's pouch. The bucconasal membrane breakdown forms the choanae - failure causes choanal atresia (high-yield PG fact).

2. Coronal Sinus Anatomy / Ostiomeatal Complex

Coronal section showing frontal sinus, olfactory cleft, lamina papyracea, ethmoid infundibulum, maxillary os, semilunar hiatus, middle turbinate, uncinate process, inferior turbinate, and maxillary sinus

Figure 26-1 - Coronal section through the sinonasal cavity. This is one of the most tested diagrams in ENT PG exams. Key structures labeled:

Uncinate process - crescent-shaped bone, shields natural maxillary ostium
Ethmoid infundibulum - bounded by uncinate process (medial), lamina papyracea (lateral), ethmoid bulla (posterosuperior)
Semilunar hiatus (Hiatus semilunaris) - crescentic 2D window into the ethmoid infundibulum
Osteomeatal complex (OMC) - region in the middle meatus; confluence of maxillary, anterior ethmoid, and frontal sinus drainage

Source: K.J. Lee's Essential Otolaryngology

3. Blood Supply of the Nasal Septum (Kiesselbach's / Little's Area)

Vascular supply of nasal septum showing anterior ethmoid, posterior ethmoid, septal branch of sphenopalatine, septal branch of superior labial, and septal branch of greater palatine arteries with Kiesselbach's plexus marked

Figure 87.12 - Vascular supply of the nasal septum (from Scott-Brown's). High-yield diagram:

Artery	Origin	Area Supplied
Anterior ethmoid artery	Internal carotid (ophthalmic a.)	Anterosuperior septum
Posterior ethmoid artery	Internal carotid (ophthalmic a.)	Posterosuperior septum
Posterior septal branch of sphenopalatine a.	External carotid (IMA)	Posteroinferior septum
Greater palatine artery (via incisive canal)	External carotid (IMA)	Anteroinferior septum
Septal branch of superior labial artery	External carotid (facial a.)	Caudal septum / columella

Kiesselbach's plexus (Little's area): Anterior nasal septum - formed by the above arteries; most common site of anterior epistaxis.

Woodruff's plexus: Posterior inferior meatus - venous; site of posterior epistaxis.

Source: Scott-Brown's Otorhinolaryngology Head & Neck Surgery, Vol 1

4. Blood Supply of the Lateral Nasal Wall

Vascular supply of lateral nasal wall showing sphenopalatine artery, anterior and posterior ethmoid arteries, and greater palatine artery

Figure 87.13 - Vascular supply of the lateral nasal wall. The sphenopalatine artery (branch of IMA from the external carotid) enters via the sphenopalatine foramen just inferior to the horizontal attachment of the middle turbinate. The crista ethmoidalis (perpendicular plate of palatine bone) is the surgical landmark to identify the sphenopalatine artery during endoscopic dissection.

Source: Scott-Brown's Otorhinolaryngology Head & Neck Surgery, Vol 1

5. Nasolacrimal System

Nasolacrimal drainage system showing upper and lower lacrimal puncta, canaliculi, valve of Rosenmüller, common canaliculus, lacrimal sac, nasolacrimal duct, valve of Hasner, inferior turbinate, and inferior meatus

Figure 26-3 - Nasolacrimal system (from KJ Lee's). Drainage pathway:

Upper/lower lacrimal punctum → Canaliculi → Valve of Rosenmüller (prevents reflux) → Lacrimal sac → Nasolacrimal duct → Valve of Hasner → Inferior meatus (opens ~1 cm posterior to head of inferior turbinate)

Source: K.J. Lee's Essential Otolaryngology

6. Lacrimal Bone and Lacrimal Fossa

Lacrimal bone anatomy showing lacrimal bone, frontal process of maxilla, nasal bone, lacrimal-maxillary suture (lacrimal line), anterior and posterior lacrimal crests, lacrimal fossa

Figure 26-2 - Lacrimal bone anatomy. The lacrimal (maxillary) line = suture between frontal process of maxilla and lacrimal bone - key endoscopic landmark for dacrocystorhinostomy (DCR). The lacrimal sac lies mostly above the middle turbinate axilla.

Source: K.J. Lee's Essential Otolaryngology

7. Sphenoid Sinus Pneumatization Patterns

Three sagittal CT images showing (a) sellar, (b) pre-sellar, and (c) conchal types of sphenoid sinus pneumatization

Figure 87.6 - Sphenoid sinus pneumatization patterns on sagittal CT:

(a) Sellar type - 90% - most common; pneumatization extends to sella
(b) Pre-sellar type - 9% - pneumatization does not reach sella
(c) Conchal type - 1% - minimal pneumatization

Critical for surgical planning of transphenoidal approaches to pituitary tumours. Source: Scott-Brown's Otorhinolaryngology Head & Neck Surgery, Vol 1

8. Paranasal Surgical Box (FESS Anatomy)

Schematic diagram of right paranasal surgical box showing horizontal and vertical components with colour-coded boundaries: medial orbital wall (blue), middle turbinate (grey), skull base (green), sphenoid (yellow), anterior nasal beak (red)

Figure 87.14 - Schematic of the right paranasal surgical box (Scott-Brown's). Defines safe boundaries in FESS:

Boundary	Horizontal box	Vertical box
Medial	Middle turbinate (grey)	Middle turbinate + intersinus septum (grey)
Lateral	Lamina papyracea / medial orbital wall (blue)	Lamina papyracea (blue)
Superior	Skull base (green)	Skull base (green)
Inferior	Floor of nose	-
Anterior	-	Nasofrontal beak (red)
Posterior	-	Sphenoid sinus (yellow)

Source: Scott-Brown's Otorhinolaryngology Head & Neck Surgery, Vol 1

Key Facts Summary for PG Exam

Lateral nasal wall lamellae (anterior to posterior):

Uncinate process
Ethmoid bulla
Basal lamella of middle turbinate (divides anterior from posterior ethmoid)
Basal lamella of superior turbinate
Basal lamella of supreme turbinate (when present)

Meatal drainage patterns:

Inferior meatus: Nasolacrimal duct (Valve of Hasner)
Middle meatus (OMC): Frontal sinus, anterior ethmoid, maxillary sinus
Superior meatus + sphenoethmoidal recess: Posterior ethmoid + sphenoid sinus

Osteology of lateral nasal wall (anterior to posterior): Frontal process of maxilla → Lacrimal bone → Lamina papyracea (superior) / Medial maxillary wall (inferior) → Perpendicular plate of palatine bone → Medial pterygoid plate of sphenoid

Middle turbinate attachments (3 planes):

Anterior: Sagittal plane - cribriform plate/lateral lamella
Middle (basal lamella): Coronal plane - lamina papyracea
Posterior: Axial plane - crista ethmoidalis of perpendicular palatine bone (near sphenopalatine foramen)

Concha bullosa: Pneumatized middle turbinate (1/3 of population) - most common anatomical variant.

All diagrams sourced from Scott-Brown's Otorhinolaryngology Head & Neck Surgery (Vol 1) and K.J. Lee's Essential Otolaryngology - standard references for ENT postgraduate examinations.

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