Superior Nasal Concha

The superior nasal concha, also called the superior turbinate, is a small curved bony projection from the upper part of the lateral wall of the nasal cavity. It is a component of the ethmoid bone and lies superior and posterior to the larger middle nasal concha.

The superior nasal concha forms the superior boundary of the superior nasal meatus and lies close to the specialized olfactory region of the nasal cavity. Its position contributes to the organization of nasal airflow, while the meatus beneath it receives drainage from the posterior ethmoidal air cells.

Location

The superior nasal concha is located in the posterosuperior portion of the nasal cavity.

It projects medially from the ethmoidal labyrinth of the lateral nasal wall and lies above the middle nasal concha.

Bony Origin

The superior nasal concha is an integral part of the ethmoid bone.

It arises from the medial surface of the ethmoidal labyrinth, which also gives rise to the middle nasal concha.

Relationship to the Ethmoid Bone

The ethmoid bone contributes to the roof, lateral walls, and nasal septum of the nasal cavity.

The superior and middle nasal conchae are projections of the ethmoidal labyrinth, whereas the inferior nasal concha is a separate bone.

Size and Shape

The superior nasal concha is generally smaller and shorter than both the middle and inferior nasal conchae.

It forms a thin, curved plate that projects medially and somewhat inferiorly into the superior portion of the nasal airway.

Comparison of the Nasal Conchae

Concha	Bony Origin	Relative Size	Associated Passage
Superior nasal concha	Ethmoid bone	Small	Superior nasal meatus
Middle nasal concha	Ethmoid bone	Intermediate	Middle nasal meatus
Inferior nasal concha	Independent bone	Largest	Inferior nasal meatus

Superior Nasal Meatus

The superior nasal meatus is a narrow passage located immediately inferior to the superior nasal concha.

It lies between the superior and middle nasal conchae and occupies the posterior part of the upper nasal cavity.

Posterior Ethmoidal Air Cells

The posterior ethmoidal air cells open into the superior nasal meatus.

Secretions from these cells therefore enter the nasal cavity beneath the superior nasal concha.

Ethmoidal Air Cell Drainage

Ethmoidal Group	Principal Drainage Site
Anterior ethmoidal air cells	Middle nasal meatus
Middle ethmoidal air cells	Middle nasal meatus, commonly on or near the ethmoidal bulla
Posterior ethmoidal air cells	Superior nasal meatus

Sphenoethmoidal Recess

The sphenoethmoidal recess lies superior and posterior to the superior nasal concha.

It is a distinct recess rather than one of the three principal nasal meatuses.

Sphenoidal Sinus Relationship

The sphenoidal sinus opens into the sphenoethmoidal recess above and posterior to the superior nasal concha.

The superior concha is therefore an important landmark for locating the sphenoidal sinus drainage region.

Relationship to the Middle Nasal Concha

The middle nasal concha lies inferior and anterior to the superior nasal concha.

The superior nasal meatus occupies the interval between these two ethmoidal projections.

Relationship to the Nasal Septum

The superior nasal concha projects medially toward the upper nasal septum.

The space between the concha and septum forms part of the superior nasal airway and contributes to the passage of air toward the olfactory region.

Relationship to the Nasal Roof

The superior nasal concha lies close to the roof of the nasal cavity.

The nasal roof in this region is formed in part by the cribriform plate of the ethmoid bone, which separates the nasal cavity from the anterior cranial fossa.

Cribriform Plate

The cribriform plate is the horizontal portion of the ethmoid bone forming a major part of the roof of the nasal cavity.

Numerous small foramina within the plate transmit bundles of olfactory nerve fibers from the nasal mucosa to the olfactory bulbs.

Olfactory Region

The superior nasal concha lies within or adjacent to the olfactory region of the nasal cavity.

Olfactory mucosa occupies the superior part of the nasal cavity, including portions of the superior nasal concha, adjacent upper nasal septum, and roof.

Olfactory Epithelium

Olfactory epithelium is specialized sensory epithelium containing olfactory receptor neurons, supporting cells, and basal cells.

Its distribution differs from the respiratory epithelium covering most of the remainder of the nasal cavity.

Olfactory Nerve Fibers

Axons of olfactory receptor neurons gather into small bundles that form the olfactory nerve filaments.

These fibers pass through foramina in the cribriform plate and terminate in the olfactory bulb.

Relationship to Olfactory Bulb

The olfactory bulbs lie superior to the cribriform plate within the anterior cranial fossa.

This places the olfactory mucosa of the superior nasal cavity in close anatomical relationship with the central olfactory pathways.

Airflow and Olfaction

Odorant molecules must reach the olfactory mucosa to stimulate olfactory receptor neurons.

The position of the superior concha and surrounding nasal passages influences airflow toward the superior nasal cavity and therefore contributes indirectly to olfactory function.

Respiratory Function

Like the other nasal conchae, the superior concha increases the surface complexity of the nasal cavity.

Its mucosal covering participates in conditioning inspired air while its shape contributes to distribution of airflow through the upper nasal passage.

Warming Inspired Air

The nasal mucosa contains an extensive vascular network that transfers heat to inspired air.

The conchae increase mucosal surface area and promote contact between inspired air and the vascular lining of the nasal cavity.

Humidification

The moist mucosal surfaces of the nasal cavity add water vapor to inspired air.

The curved surfaces of the conchae increase the area available for this exchange.

Filtration

Mucus covering respiratory portions of the nasal mucosa traps inhaled particles.

Airflow around the conchae increases interaction between inspired air and the mucosal surface, contributing to filtration before air reaches the lower respiratory tract.

Mucociliary Clearance

Respiratory regions of the nasal cavity contain ciliated epithelium.

Cilia transport mucus and trapped material toward the nasopharynx, where it can be swallowed or otherwise cleared.

Mucosal Covering

The mucosa covering the superior nasal concha is not uniform.

Its superior region is associated with specialized olfactory mucosa, while neighboring areas participate in the respiratory lining of the nasal cavity.

General Sensory Innervation

General sensation from the nasal cavity is supplied by branches of the trigeminal nerve.

The anterosuperior nasal cavity receives sensory fibers primarily through branches associated with the ophthalmic division of the trigeminal nerve.

Anterior Ethmoidal Nerve

The anterior ethmoidal nerve arises from the nasociliary nerve, a branch of the ophthalmic division of the trigeminal nerve.

Its internal nasal branches provide general sensory innervation to portions of the superior and anterior nasal cavity.

Posterior Superior Nasal Innervation

Posterior superior regions of the nasal cavity also receive sensory branches associated with the maxillary division of the trigeminal nerve through the pterygopalatine region.

The precise sensory territories overlap with neighboring nasal structures.

Special Sensory Innervation

Olfactory sensation is carried by the olfactory nerve.

Olfactory receptor neurons located in specialized mucosa send their axons through the cribriform plate to synapse within the olfactory bulb.

General and Special Sensation

Modality	Principal Neural Pathway
General sensation	Branches of trigeminal nerve
Olfaction	Olfactory receptor neurons and olfactory nerve fibers

Autonomic Innervation

Autonomic fibers regulate glandular secretion and vascular tone in the nasal mucosa.

Parasympathetic fibers primarily stimulate secretion, while sympathetic fibers contribute to vasomotor regulation.

Parasympathetic Supply

Preganglionic parasympathetic fibers associated with the facial nerve travel through the greater petrosal nerve and reach the pterygopalatine ganglion.

Postganglionic fibers are distributed to nasal glands along branches associated with the maxillary nerve.

Sympathetic Supply

Postganglionic sympathetic fibers arise from the superior cervical ganglion and travel through periarterial plexuses and the deep petrosal nerve.

They reach the nasal cavity through pathways associated with the pterygopalatine region and contribute to regulation of mucosal blood vessels.

Blood Supply

The superior nasal region receives arterial supply from branches of several vessels.

Important contributions include the anterior and posterior ethmoidal arteries and branches of the sphenopalatine artery.

Anterior and Posterior Ethmoidal Arteries

The ethmoidal arteries arise from the ophthalmic artery.

They pass through corresponding ethmoidal canals and supply portions of the superior nasal cavity, ethmoidal air cells, and adjacent structures.

Sphenopalatine Artery

The sphenopalatine artery is a terminal branch of the maxillary artery.

Its nasal branches contribute to the blood supply of posterior portions of the nasal septum and lateral nasal wall.

Venous Drainage

Veins of the superior nasal cavity participate in extensive venous networks.

These networks communicate with veins of the nasal cavity, orbit, facial region, and pterygoid venous plexus.

Relationship to the Orbit

The superior nasal concha arises from the ethmoidal labyrinth, which lies immediately medial to the orbit.

The thin orbital plate of the ethmoid separates the ethmoidal air cells from orbital contents.

Relationship to the Anterior Cranial Fossa

The superior nasal cavity lies immediately inferior to the anterior cranial fossa.

The cribriform plate forms a thin bony boundary between these regions and transmits olfactory nerve fibers.

Relationship to the Posterior Ethmoidal Cells

Posterior ethmoidal air cells lie within the ethmoidal labyrinth near the superior meatus.

Their openings into the superior meatus establish an important relationship between the superior concha and ethmoidal sinus drainage.

Relationship to the Sphenoid

The sphenoid bone lies posterior to the ethmoid bone.

The sphenoidal sinus opens into the sphenoethmoidal recess immediately superior and posterior to the superior nasal concha, making the concha a useful landmark for this region.

Supreme Nasal Concha

A small supreme nasal concha may occur superior to the superior nasal concha as an anatomical variation.

When present, it is also associated with the ethmoid bone and may create a small additional meatus.

Anatomical Variation

The size, length, orientation, and surrounding air-cell configuration of the superior nasal concha vary among individuals.

Variation in ethmoidal pneumatization can alter the relationships among the superior meatus, posterior ethmoidal cells, sphenoethmoidal recess, and neighboring skull base.

Nasal Obstruction

Mucosal swelling or structural narrowing in the superior nasal cavity can alter airflow through the region.

Because the superior meatus is relatively small, changes in the surrounding mucosa may also affect drainage of posterior ethmoidal air cells.

Posterior Ethmoidal Sinus Disease

Inflammation involving posterior ethmoidal air cells may affect drainage through the superior meatus.

The close relationships of these cells to the orbit, skull base, and sphenoidal region are important when evaluating posterior ethmoidal anatomy.

Nasal Endoscopy

The superior nasal concha can serve as a landmark during examination of the posterior and superior nasal cavity.

Identification of this region helps orient the examiner to the superior meatus and sphenoethmoidal recess.

Endoscopic Access to the Sphenoidal Sinus

The sphenoethmoidal recess is an important region during endoscopic approaches to the sphenoidal sinus.

The superior nasal concha provides a nearby anatomical landmark for identifying this posterior superior portion of the nasal cavity.

Skull Base Importance

The superior nasal cavity is closely related to the thin bones of the anterior skull base.

Knowledge of the superior concha, ethmoid, cribriform plate, and neighboring air cells is therefore important for understanding the anatomy of endonasal approaches and potential pathways between the nasal and cranial cavities.

Comparison with the Middle Nasal Concha

Feature	Superior Nasal Concha	Middle Nasal Concha
Bone	Ethmoid	Ethmoid
Relative size	Smaller	Larger
Associated meatus	Superior meatus	Middle meatus
Important drainage relationship	Posterior ethmoidal air cells	Frontal, maxillary, anterior and middle ethmoidal drainage pathways
Olfactory relationship	Closely associated with olfactory region	Predominantly respiratory region

Key Anatomical Relationships

• The superior nasal concha is part of the ethmoid bone.
• It lies in the posterosuperior part of the nasal cavity.
• It is smaller than the middle and inferior nasal conchae.
• The superior nasal meatus lies immediately inferior to it.
• Posterior ethmoidal air cells drain into the superior nasal meatus.
• The sphenoethmoidal recess lies superior and posterior to the concha.
• The sphenoidal sinus opens into the sphenoethmoidal recess.
• The superior concha lies close to the olfactory region.
• Portions of its mucosa may contain olfactory epithelium.
• Olfactory nerve fibers pass through the nearby cribriform plate.
• The ethmoidal labyrinth lies between the nasal cavity and orbit.
• The superior nasal cavity lies immediately inferior to the anterior cranial fossa.
• The superior concha contributes to airflow regulation and conditioning of inspired air.
• It is an important landmark for the superior meatus and sphenoethmoidal recess.

Clinical Importance

The superior nasal concha is a small but anatomically important component of the upper nasal cavity. Its relationship with the superior nasal meatus makes it closely associated with drainage of the posterior ethmoidal air cells, while the sphenoethmoidal recess immediately above and behind it receives the sphenoidal sinus opening.

Its position near the olfactory mucosa, cribriform plate, ethmoidal air cells, orbit, and anterior cranial base also makes the superior concha an important landmark for understanding the complex anatomy of the superior nasal cavity.

Understanding the superior nasal concha provides the anatomical foundation for studying nasal airflow, olfaction, posterior ethmoidal drainage, the superior nasal meatus, sphenoethmoidal recess, sphenoidal sinus anatomy, nasal endoscopy, and skull base relationships.