The nasal cavity is the air-filled space within the nose, divided by the nasal septum and communicating with the nasopharynx posteriorly and the external nares anteriorly. The lateral nasal walls bear three turbinates (conchae): the superior turbinate (with the olfactory cleft above), the middle turbinate (with the ostiomeatal complex opening sinuses), and the inferior turbinate (with the nasolacrimal duct). The meati below each turbinate receive the sinus ostia.
The nasal cavity is the surgical domain of functional endoscopic sinus surgery (FESS): the ostiomeatal complex in the middle meatus receives the frontal, anterior ethmoid, and maxillary sinus ostia, and their obstruction causes chronic rhinosinusitis. FESS opens the ostiomeatal complex to restore sinus drainage. Epistaxis most commonly occurs from Little's area on the anterior septum (Kiesselbach's plexus — convergence of septal branches from the sphenopalatine, anterior ethmoidal, greater palatine, and superior labial arteries). Nasal endoscopy guides diagnosis and treatment of sinonasal tumours, polyps, and CSF rhinorrhoea.
Anatomical or inflammatory narrowing of the ostiomeatal complex in the middle meatus blocks the common drainage pathway for the maxillary, anterior ethmoid, and frontal sinuses, producing recurrent rhinosinusitis with mucopurulent discharge, facial pain, and nasal obstruction; FESS removes obstructing tissue and widens the ostia to restore mucociliary clearance.
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