of Cases % Agger nasi
9 17.3% Pneumatisation of MT 18 34.6% Enlarged ethmoidal bulla 7 13.4% Paradoxical MT 6 11.5% Everted uncinate 1 1.9% Haller cell 4 7.6% Onodi cell 6 11.5% Frontal sinus cells 6 11.5% Table 7.
90% of the patients with right sided disease had DNS to right, with associated bilateral concha bullosa in 20% and left agger nasi
cell in 10%.
The agger nasi
cell in frontal recess obstruction: Anatomic and clinical correlation.
Post-treatment CT demonstrated thickening in the ethmoid and maxillary sinuses; a single frame from this scan showed the agger nasi
cell (figure 1).
Opening the agger nasi
cells usually provides a good view of the frontal recess.
Depending on the degree of pneumatization, agger nasi
cells can be bounded anteriorly by the frontal process of the maxilla, anterolaterally by the nasal and lacrimal bones, posterolaterally by the lamina papyracea, superiorly by the frontal sinus, inferolaterally by the uncinate process, and posteriorly by the anterior ethmoid complex.
Table 2 Our risk-assessment scoring system Structure Left Right Absent frontal sinus 0 or 1 0 or 1 Absent sphenoid sinus 0 or 1 0 or 1 Agger nasi
cells 0 or 1 0 or 1 Asymmetric sphenoid septum 0 or 1 0 or 1 Cribriform plate 0 or 1 0 or 1 Haller's cells 0 or 1 0 or 1 Internal carotid cover 0 or 1 0 or 1 Lamina papyracea 0 or 1 0 or 1 Optic nerve cover 0 or 1 0 or 1 Pneumatized ethmoid roof 0 or 1 0 or 1 Uncinate process 0 or 1 0 or 1 Key: 0: normal; 1: definite anomaly.
Middle turbinate, Concha Bullosa, Uncinate process, Agger Nasi
cells, Haller cells and Posterior ethmoids showed very good agreement.
It is also important to avoid excessive removal near the attachment of the vertical portion of the middle turbinate or the agger nasi
because this might disrupt the attachment to the cribriform plate.
Cells: We found pneumatization of the agger nasi
cells in 58(72.5%) nasal cavities.
The intra and extramural pneumatisation of the ethmoid air cells was seen in 70% of the cases, with the Agger nasi
cells being most common type.
Polyps blocking the frontal recess opening into the middle meatus were cleared, agger nasi
cells were exenterated, and mucus was drained from the frontal sinus.