In functional endoscopic sinus surgery (FESS), the 'key' structure that must be identified first to safely open the anterior ethmoid complex is:
- A Agger nasi cell
- B Middle turbinate axilla
- C Uncinate process ✓
- D Bulla ethmoidalis
Correct answer: C. Uncinate process
Explanation
The uncinate process is the first structure removed in FESS (uncinectomy), as it forms the medial wall of the infundibulum and directly overlies the maxillary sinus ostium. Removing the uncinate exposes the ethmoid infundibulum and allows safe identification of the natural maxillary ostium before proceeding to bulla ethmoidalis and posterior ethmoid. The agger nasi is addressed when frontal recess surgery is needed, not as the first step for anterior ethmoidectomy.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.