78 THE NASAL ACCESSORY SINUSES IN MAN 



communication found between a posterior ethmoidal cell 

 and the sphenoidal sinus. 



CELLULJE CONCHALES 



Pneumatization of the conchse ethmoidales is a rather 

 common condition, occurring in from 4 per cent, to 18 per 

 cent, of cases studied by various observers. In this series 

 such cells were found in 8 per cent, of cases over ten years of 

 age, and in 3 per cent, under that age. Observations as to 

 their possible points of origin are in accord with the studies 

 made by J. P. Schaeffer. In the majority of instances such 

 cells developed as extensions of posterior ethmoidal cells 

 communicating with the superior meatus, but other cases 

 showed origins from the posterior extremity of the infundib- 

 ulum ethmoidale, and still others from the suprabullar furrow 

 (Fig. 46). 



The mucosa lining these cells was similar to that lining 

 other ethmoidal cells. In none of these cases did the cells 

 contain fluids or granulation tissue. However, one can 

 readily see how some of the earlier observers, who found such 

 turbinates in diseased condition, came to regard the conchal 

 cells as cysts. 



In many instances the stimulus exciting the development 

 of these cells seems to have been produced by a deflection 

 of the septum nasi, the concha media on the side of the 

 concavity showing the presence of an air-cell in its anterior 

 portion, thus aiding in its compensatory hypertrophy. 

 Fig. 46 illustrates such a case, but the stimulus in all cases 

 cannot be attributed to such a cause, since occasionally 

 specimens have been observed in which both middle conchse 

 contained such cells. 



