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Anatomic misconceptions regarding the agger nasi cell: A preliminary analysis utilizing endoscopic anatomic
William E Bolger1, Masaru Ishii2
1Division of Otorhinolaryngology, University of Florida Medical School, Jacksonville, Florida, USA.
Clinical Anatomy (New York, N.Y.)
|November 29, 2022
Summary
The agger nasi cell
Area of Science:
- Otolaryngology
- Surgical Anatomy
- Medical Imaging
Background:
- The agger nasi cell is a critical landmark in endoscopic frontal sinus surgery.
- Variability in its definition and prevalence challenges its reliability as a surgical landmark.
Purpose of the Study:
- To evaluate the agger nasi cell's anatomy and prevalence using radiographic imaging and endoscopic dissection.
- To assess the utility of three-dimensional computed tomography (3D-CT) in visualizing this anatomy for surgical planning.
Main Methods:
- Analysis of CT scans (triplanar and 3D-CT) from 11 cadaveric sinonasal complexes.
- Correlation with video-recorded endoscopic dissections to identify agger nasi pneumatization and origin.
- Detailed examination of 3D-CT for microanatomic feature visualization.
Main Results:
- Pneumatization in the agger nasi region was observed in 36.4% of cases.
- Solid, unpneumatized bone was present in 36.4% of cases.
- Limited pneumatization was noted in 27.3% of cases, with variations in origin.
Conclusions:
- The agger nasi cell's variable anatomy and prevalence can be confusing for surgical trainees.
- Standard CT may have limitations compared to dissection; however, 3D-CT offers enhanced visualization for surgical road mapping.
