Evolution of the paranasal sinuses' anatomy through the ages

Abstract

Previously, anatomists considered paranasal sinuses as a mysterious region of the human skull. Historically, paranasal sinuses were first identified by ancient Egyptians and later, by Greek physicians. After a long period of no remarkable improvement in the understanding of anatomy during the Middle Ages, anatomists of the Renaissance period-Leonardo da Vinci and Vesalius-made their own contribution. Nathaniel Highmore's name is also associated with the anatomy of paranasal sinuses as he was first to describe the maxillary sinus.

Keywords: Anatomy; History; Paranasal sinuses.

Fig. 1

Leonardo da Vinci's depiction of a skull. The image is one of da Vinci's anatomical drawings of a human skull. The left half of the skull is sectioned to reveal the frontal sinus and the maxillary sinus. Of note is the close relation of the two sinuses to the orbit and the teeth of the upper jaw, as understood by Leonardo. Reprinted from Leonardo Da Vinci's drawings [11].

Fig. 2

Vesalius' images of the skull and the sphenoid bone. The images constitute anatomical drawings from Vesalius' work 'De Humani Corporis Fabrica.' Most of the illustrations in this book were created by Jan Stephan van Calcar, an Italian artist, one of Titian's students. The left half of the picture shows a transverse cross-section of the skull, depicting the calvaria whereas the right half shows the sphenoid bone. The right-hand image shows the frontal sinus as well as the two sphenoid sinuses, which are separated by the sphenoid septum. Reprinted from Andreas Vesalius, De Humani Corporis Fabrica [13].

Fig. 3

Illustrations from Nathaniel Highmore's book 'Corporis Humani Disquisitio Anatomica.' The maxillary sinus and the projection of the teeth of the upper jaw into the floor of the sinus are clearly shown. The cross-section of the skull in the bottom right of the picture reveals the frontal sinus, sphenoid sinus, ethmoid cells and maxillary sinus. Reprinted from Nathaniel Highmore, Corporis humani disquisitio anatomica, p. 227 [19].