[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Head and neck](https://durgical.com/en/anatomy/region/head-and-neck/) › Ethmoid cells [Skeletal system](https://durgical.com/en/anatomy/system/skeletal-system/) · [Head and neck](https://durgical.com/en/anatomy/region/head-and-neck/) # Ethmoid cells The ethmoid cells are many small air spaces between the eyes; they drain into the nose, and an infection there can spread to the eye socket. Official name: Anterior cells of ethmoid bone [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=head_neck&select=ethmoid_cells&side=r) Opens in the Durgical app, no sign-up needed. ## What it is Many small air cells between the eyes. ## What it does Drain into the nose; infection can spread to the eye socket. ## Key points - In children, ethmoid sinusitis is the most common source of orbital cellulitis, spreading through the thin lamina papyracea and its veins - Chandler stages of orbital spread: preseptal cellulitis, orbital cellulitis, subperiosteal abscess, orbital abscess, [cavernous sinus](https://durgical.com/en/anatomy/cavernous-sinus/) thrombosis - Anterior and middle cells drain to the middle meatus (ostiomeatal complex); posterior cells drain to the superior meatus ## Key facts **Where** Between the orbits (anterior, middle, posterior groups) **Blood supply** Ethmoidal arteries **Nerve** V1 (nasociliary), V2 **Function** Air cells; thin orbital wall (lamina papyracea) lets infection reach the orbit ## Relations **Lateral** Orbit through the lamina papyracea; the [medial rectus](https://durgical.com/en/anatomy/medial-rectus-muscle/), and the anterior and posterior ethmoidal arteries crossing at the roof **Above** Ethmoid roof (fovea ethmoidalis) and [cribriform plate](https://durgical.com/en/anatomy/cribriform-plate/), separating them from the anterior cranial fossa and frontal lobes **Medial** Superior and middle conchae and the upper [nasal cavity](https://durgical.com/en/anatomy/nasal-cavity/) **Behind** [Sphenoid sinus](https://durgical.com/en/anatomy/sinus-of-sphenoid-bone/); posterior cells can lie next to the [optic nerve](https://durgical.com/en/anatomy/optic-nerve/) **Below** [Maxillary sinus](https://durgical.com/en/anatomy/maxillary-sinus/) and the ostiomeatal complex in the middle meatus **In front** Frontal recess and [lacrimal bone](https://durgical.com/en/anatomy/lacrimal-bone/) ## How to find it They cannot be felt; tenderness at the inner corner of the eye can accompany ethmoid sinusitis. Endoscopically the cells are opened through the middle meatus, usually starting at the ethmoid bulla. ## Examination - Eye movements, vision, colour vision and pupils: pain on eye movement, restricted movement, proptosis or a relative afferent pupillary defect mark orbital rather than preseptal cellulitis ## On imaging Contrast CT of the orbits and sinuses separates preseptal from orbital cellulitis and shows a subperiosteal abscess along the lamina papyracea; coronal CT maps the cells before surgery. ## Common problems - Sinusitis: blocked nose, thick discharge, pressure in the cheeks or teeth. - Most acute sinusitis is viral; some becomes chronic. ## How it is diagnosed Symptoms and exam; nasal endoscopy and CT for chronic or complicated cases. ## Treatment - Saline rinses, nasal steroid sprays, pain relief; antibiotics only for bacterial cases. - Endoscopic sinus surgery for chronic sinusitis. ## Clinical notes - In endoscopic sinus surgery the anterior ethmoidal artery at the skull base and the lamina papyracea are key landmarks; injury can cause an orbital haematoma or CSF leak - The ostiomeatal complex is the shared drainage path of the frontal, maxillary and anterior ethmoid sinuses, so a blockage there can affect all three ## Anatomical variants - Agger nasi cell: the most anterior ethmoid cell, in front of the middle concha attachment, present in most people - Haller (infraorbital ethmoid) cells along the orbital floor can narrow the outflow of the maxillary sinus - Onodi (sphenoethmoidal) cells extend above or beside the sphenoid sinus and can lie against the optic nerve, a surgical risk - Concha bullosa: an air-filled middle concha, which can narrow the middle meatus ## Development Present at birth and enlarging through childhood, which is why ethmoid sinusitis is seen even in infants. ## Related conditions - [Acute rhinosinusitis](https://durgical.com/en/conditions/acute-rhinosinusitis/) - [Orbital cellulitis](https://durgical.com/en/conditions/orbital-cellulitis/) - [Chronic rhinosinusitis and nasal polyps](https://durgical.com/en/conditions/chronic-rhinosinusitis-and-nasal-polyps/) ## Test yourself Think of the answer, then tap the question to see it. ## What is the most common source of orbital cellulitis in children, and how does it spread? Ethmoid sinusitis, spreading through the thin lamina papyracea and its veins. ## What are the Chandler stages of orbital spread from the ethmoid cells? Preseptal cellulitis, orbital cellulitis, subperiosteal abscess, orbital abscess, cavernous sinus thrombosis. ## Where do the anterior, middle and posterior ethmoid cells drain? Anterior and middle cells to the middle meatus (ostiomeatal complex); posterior cells to the superior meatus. ## Why is an Onodi cell a surgical risk among the ethmoid cells? This posterior ethmoid cell extends above or beside the sphenoid sinus and can lie against the optic nerve. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/anatomy/anterior-cells-of-ethmoid-bone/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** cellulae anteriores ossis ethmoidei TA2 729 **Official Spanish (DeCS)** Senos Etmoidales DeCS D005005 **English (TA2)** Anterior cells of ethmoid bone **Also called** ethmoid sinus · bony anterior ethmoidal cells · sinus ethmoidei anteriores · cellulae ethmoidales anteriores osseae Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=5097); [Anatomy, Head and Neck, Nose Paranasal Sinuses](https://www.ncbi.nlm.nih.gov/books/NBK499826/); [Anatomy, Head and Neck, Nose Sinuses](https://www.ncbi.nlm.nih.gov/books/NBK513272/). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/anterior-cells-of-ethmoid-bone/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/anterior-cells-of-ethmoid-bone/