During endoscopic dissection of the frontal recess, the surgeon encounters the most anterior and inferior ethmoid air cell, which forms the posteromedial boundary of the frontal sinus outflow tract. Persistent disease in this cell is the commonest cause of failed frontal sinus drainage. Which cell is this?

• A Agger nasi cell ✓
• B Suprabullar cell
• C Frontal bullar cell
• D Interfrontal sinus septal cell

Explanation

The agger nasi cell is the most anterior ethmoid air cell, lying just anterior and inferior to the frontal recess. Its size directly determines the patency of the frontal sinus outflow tract, and residual agger nasi disease is the leading cause of iatrogenic frontal recess stenosis after surgery. Suprabullar and frontal bullar cells lie above the ethmoid bulla, and the interfrontal septal cell lies between the two frontal sinuses.

Reference: Cummings Otolaryngology Head and Neck Surgery, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.