Question about agger nasi-related pathologies

[drivesmecraazee]

Shadowing an ENT I heard the agger nasi could give a considerable amount of problems, could someone tell me wich are the most common pathologies related to the agger nasi? How do you threat them?
Thanks a lot.

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[drivesmecraazee]

I just hope resxn, throat, chirurgino, pir8deacdoc, leforte, aggernodi or blz were one of the 32 members that read my question, since they usually answer these things...but anyone who knows this is free to answer too...c'mon you guys, Im curious.

 

[Leforte]

I'll bite - but just because I should be studying for the inservice and will find anything to procrastinate.

If you are interested in sinus disease/anatomy - read these websites (just googled them):

http://www.sinustreatmentcenter.com/sinusanatomy06.html

http://www.utmb.edu/otoref/grnds/Paranasal-Sinus-2002-01/Paranasal-sinus-2002-01-slides.pdf

http://lib.bioinfo.pl/pmid:15467630

BTW - a good site for quick reference on most ENT topics is the UTMB Grand Rounds database -

http://www.utmb.edu/otoref/Grnds/GrndsIndex.html

It's a good place to get a fast overview before a surgery, etc if a student/junior resident and don't have a text readily available.

 

[drivesmecraazee]

thanks man...

 

[resxn]

The agger nasi cell really only causes people problems when they don't understand it.

If huge it can make the frontal recess narrow, that's about it. But because it's anterior and not posterior, I find that it's pretty easy to deal with.

In fact, since I've begun doing most of my frontal recess work with balloon sinuplasty in the last 18 months, I've never had a problem with it even when large.

 

[drivesmecraazee]

The agger nasi cell really only causes people problems when they don't understand it.

If huge it can make the frontal recess narrow, that's about it. But because it's anterior and not posterior, I find that it's pretty easy to deal with.

In fact, since I've begun doing most of my frontal recess work with balloon sinuplasty in the last 18 months, I've never had a problem with it even when large.

I don't get this one, are you saying the agger nasi cell only causes problems to the ENT when he doesn't understand it? Or your talking about the PATIENT?

 

[resxn]

I don't get this one, are you saying the agger nasi cell only causes problems to the ENT when he doesn't understand it? Or your talking about the PATIENT?

Talking about the ENT. I don't think you'll find too many ENT's who got good FESS training in residency who could care one lick what the agger nasi is doing for surgical planning. It's not really all that big of a deal to treat surgically. I would bet that your current ENT thinks the same thing. He's right that it can cause issues for the frontal recess--it most certainly can--but it is not that significant of a surgical issue.

It has 2 great board questions associated with it, but that's about it.

 

[drivesmecraazee]

 

[neutropeniaboy]

Shadowing an ENT I heard the agger nasi could give a considerable amount of problems, could someone tell me wich are the most common pathologies related to the agger nasi? How do you threat them?
Thanks a lot.

Isolated agger nasi sinusitis is rare. This has been associated with dacryocystitis in the past in case reports, and I've seen it once.

Beyond that, as others have suggested, the agger nasi is not a large concern. The only time I have known it to be a technical challenge is when there is a well-aerated agger nasi, a frontal bullar cell, and a large ethmoid bulla or suprabullar cell. It makes dissection timely and complicated.

Beyond that, many people open up the agger thinking they've gotten into the frontal.