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Pneumatization of the agger nasi can encroach upon and narrow the nasofrontal duct (NFD) and contribute to chronic frontal sinus disease. To investigate this, we reviewed the computed tomographic (CT) scans and surgical outcomes in 26 patients with chronic frontal sinusitis. Sagittal reformatted CT images were used to define the anatomy of the NFD as well as mucosal disease in the NFD and frontal sinus. The CT findings were correlated with the outcome of frontal sinus surgery. Our findings suggest that agger nasi cell pneumatization with narrowing of the frontal sinus outflow tract is a significant etiology of persistent frontoethmoid pain and chronic frontal sinusitis. Sagittal reformatted images are capable of demonstrating agger nasi cell encroachment on the NFD, as well as NFD mucosal disease. Endoscopic frontal sinusotomy is an effective surgical treatment for chronic frontal sinusitis.

Agger nasi cells contribute to nasofrontal duct (NFD) obstruction and chronic frontal sinus disease. To investigate this relationship, we conducted a review of the surgical outcome and computed tomographic imaging in 26 patients with chronic frontal sinusitis. Coronal and sagittal images were used to delineate the anatomic variability and mucosal disease in the NFD and frontal sinus region. Data from coronal and sagittal images were compared. The results were also correlated with the outcome of frontal sinus surgery in patients with a clinical history of chronic frontal sinus disease. Our data suggest that agger nasi cell pneumatization with narrowing of the frontal sinus outflow tract is a significant cause of persistent frontoethmoid pain and chronic frontal sinusitis. Sagittal reformatted images are more capable than coronal images of demonstrating agger nasi cell encroachment on the NFD, as well as NFD mucosal disease. Endoscopic frontal sinusotomy is an effective treatment for chronic frontal sinus disease.