Frontal sinus drainage pathway (FSDP) is a difficult area to access in endoscopic surgery of paranasal sinus region. Anatomy of this region is influenced by presence of Agger nasi cells (AN) and type of Uncinate process (UP) attachment superiorly. This retrospective descriptive study attempted to measure frequency these two important anatomical features in Indian population.

Aim: the aim of this study was to measure the frequency of agger nasi cell and evaluate their relationship with superior attachment of uncinate process

Materials and Methods: Retrospective analysis of the Non contrast computed tomograms of nose and paranasal sinus region (NCCT PNS) involving 280 sides were performed. These scans were evaluated for presence of agger nasi cells and superior attachment of uncinate process.

Results: Agger nasi cells was present in 236 of 280 sides. Uncinate process can be delineated in 272 out of 280 sides; 112  reached Lamina Papyracea (LP), 57 reached Middle Turbinate (MT) and 67 reached Skull Base (SB). Agger nasi cells were present in 88.88% sides at lamina papyracea attachment, 80.28% sides at middle turbinate attachment and 89.33% sides at skull base attachment. Statistical analysis of data provided a chi-square value of 0.2556 and P-value of 0.880. Study results indicated that relationship between the presence of agger nasi and superior attachment of uncinate process is not significant statistically at P value of < 0.05.

Conclusion: The agger nasi cell was present 84.28% scans and superior attachment of uncinate process can be traced in 97.14% of scans. However relationship was not significant between presence of agger nasi cell and superior attachment of uncinate process.

Keywords: Agger nasi cell, Uncinate process, Frontal sinus drainage pathway, Lamina papyracea, Middle turbinate, Skull base. 

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Dr Kavish Kapoor

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