This article is well-received as an article that goes into appropriate length and depth regarding the embryology and subsequent growth of the paediatric nose (internal and external), nasopharynx and all of the individual sinuses. It has excellent line diagrams of the sinuses, in particular, demonstrating their growth as the child develops. Not only do we get good descriptions of the structures and their relative growth to each other but also descriptions of their arterial supply, venous drainage and sensory supply, in addition to physiological factors. They remind the reader that the cartilaginous wall of the septum is the predominant factor for external nasal growth in early infancy. In ethmoid development, 90% of infants have ethmoid pneumatisation at birth and continue growth alongside growth of the midface. This explains why sinus complications (e.g. subperiosteal orbital abscess) can develop even in those less than six years, as a result of early ethmoid development. At birth, the maxillary sinus is also present but well above the nasal floor, expanding in all directions as the child grows. The development of the frontal sinus is more variable, with pneumatisation occurring from 12 months of age and by age six, 20-30% of child have radiographic evidence of a frontal sinus. The sphenoid sinus is the last of the sinuses to develop, usually within late childhood. This article is a good refresher for readers, especially due to diagrammatic references.

Pediatric anatomy: nose and sinus.
Zalzal HG, O’Brien DC, Zalzal GH.
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Suzanne Jervis

FRCS (ORL HNS), Shrewsbury and Telford Hospitals, NHS Trust, UK.

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