The agger nasi cell: Radiological evaluation and endoscopic management in chronic frontal sinusitis

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.