In a study conducted by Dua and Chopra16 regarding CT scan paranasal sinuses findings in CRS, they found that in majority of patients osteomeatal complex and anterior ethmoids were involved in 88% patients, agger nasi
cells in 40%, concha bullosa and Haller cells in 16% of patients.
cells lie just anterior to the anterosuperior attachment of the middle turbinate and may invade the lacrimal bone or the ascending process of the maxilla.
The relationship between the agger nasi
cell and Lund-Mackay scoring LMS (M[+ or -]SD) p (*) RIGHT AN(+) 3.5[+ or -]2.6 0.0001 AN(-) 2.3[+ or -]2.1 LEFT AN(+) 3.7[+ or -]2.9 0.0001 AN(-) 2.1 [+ or -]2.2 AN: agger nasi
cell; LMS: Lund-Mackay scoring (*) Mann-Whitney U test
Twelve areas were specifically looked at for anatomical variations (Table 1) including; Type of skull base, Anterior ethmoid artery, Agger nasi
cells, Haller cells, asymmetry in anterior ethmoidal and onodi cells.
The present study was conducted to analyse the relationship of anatomical variations and rhinosinusitis and observed variations like Concha Bullosa, Deviated Nasal Septum and Agger Nasi
which were the major conditions that led to sinusitis.
Obstructive agger nasi
cells can be removed with either conventional or powered instruments.
In this article, we describe our discovery of a naturally draining ostium of an agger nasi
We found pneumatization of the agger nasi
cells in 72.5%.
The agger nasi
cell appears as a mound or eminence in the lateral wall of the nose, anterior to the origin of the middle turbinate.
Table 2: Prevalence of Anatomical Variants associated with Sinusitis Sinus- Disease Deviated Inferior Agger Nasi
Nasal Turbinate Cells Septum Hypertrophy Maxillary sinusitis 10 12 7 Ethmoid sinusitis 12 9 5 MHMS 3 7 2 Frontal sinusitis 5 2 2 Pan-sinusitis -- 1 1 Sphenoid sinusitis 1 -- -- Total 31 31 17 Sinus- Disease Paradoxical Concha Total Middle Bullosa Turbinate Maxillary sinusitis 3 1 33 Ethmoid sinusitis 1 -- 27 MHMS -- -- 12 Frontal sinusitis 1 1 11 Pan-sinusitis -- -- 2 Sphenoid sinusitis -- -- 1 Total 5 2 86 Note: MHMS, mucosal hypertrophy of maxillary sinus.
Bolger et al (15) in 1991 and Lund et a1 (8) in 1997 reported that there were wide variations in the reported prevalence of anomalies in the agger nasi
, concha bullosa, and Haller's cells.
The parameters used for correlation were- Deviated Nasal Septum, Inferior Turbinate Hypertrophy, Middle Turbinate abnormalities, Concha Bullosa, Agger Nasi
cells, Haller cells, Frontal recess, Infundibulum, Hiatus semilunaris, Uncinate process attachment, Intrasinus mucosal disease of Maxillary, Ethmoids, Frontal and Sphenoid detailed history, clinical examination and routine investigations were done for the patients.