[Anatomical and computed tomographic analysis of the interaction between uncinate process and agger nasi cells].
OBJECTIVE
To investigate the anatomical interaction between uncinate process and agger nasi cell to better understand the anatomy of the frontal sinus drainage pathway by endoscopy, spiral computed tomography (CT) and sectioning.


METHODS
Twenty-one skeletal skulls (forty-two sides) and one cadaver head (two sides) were studied by spiral CT together with endoscopy and collodion embedded thin sectioning at coronal plane. The sections with the thickness of 100 microm were stained with hemotoxylin and eosin.


RESULTS
Under endoscopy, a leaflet of bone to the middle turbinate, which is given off by uncinate process, forms the anterior insertion of the middle turbinate onto the lateral nasal wall. The middle portion of the uncinate process attached to the frontal process of the maxilla in all of the skeletal nasal cavities, as well as the lacrimal bone in 78.6% of the skeletal nasal cavities. On CT scans, the agger nasi cell is present in 90.5% of the skeletal nasal cavities. While the lateral wall of the agger nasi cell is formed by lacrimal bone, the medial wall of the agger nasi cell is formed by uncinate process. And the anterior wall is formed by the frontal process of the maxilla. The superior portion of the uncinate process forms the medial, posterior and top wall of the agger nasi cells. The superior portion of the uncinate extends into the frontal recess and may insert into lamina papyracea (33.3%), skull base (9.5%), middle turbinate, combination of these (57.2%).


CONCLUSIONS
The agger nasi cell is the key that unlocks the frontal recess.
Zhang
Luo
L
Beijing Institute of Otorhinolaryngology, Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Beijing Tongren Hospital of Capital University of Medical Sciences, China. luozhang@trhos.com
Han
De-min
DM
Ge
Wen-tong
WT
Zhou
Bing
B
Xian
Jun-fang
JF
Liu
Zhong-yan
ZY
Wang
Kui-ji
KJ
He
Fei
F
D000328:Adult; D005626:Frontal Sinus / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D006801:Humans; D021621:Imaging, Three-Dimensional; D009296:Nasal Cavity / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D036542:Tomography, Spiral Computed; D014420:Turbinates / Q000033:anatomy & histology / Q000000981:diagnostic imaging