2 Radiological Anatomy

Claudia Kirsch

Abstract

The complex variable frontal sinus drainage pathway anatomy on radiographic imaging appears different viewed endoscopically; however, awareness of the multiple alternate drainage pathways is vital to prevent potential surgical complications and is confounded by redundant and confusing terminology. Despite newer imaging techniques, major complications from frontal sinus surgery still occur. This chapter’s goal is to improve radiographic visualization and understanding of the frontal sinus drainage pathway anatomy starting from development to the multitude of presentations found on computed axial tomography of the paranasal sinuses. The following mnemonic is a helpful reminder that “radiology of the frontal sinus drainage pathway requires you to Look Precisely UP FOR AN Accessory air cell, Ethmoidal Arteries, and BE Mentally Trained.” This mnemonic is a reminder to visually check on the CT scan critical anatomy, the “Look Precisely UP FOR AN Accessory Air cell, Ethmoidal Arteries, and BE Mentally Trained” represent the “Lamina Papyracea” of the orbit, the “Uncinate Process,” “Floor of the Olfactory Recess,” “Agger Nasi air cell,” “Accessory Air cells,” “Ethmoidal Arteries,” and “BE Mentally Trained” reminds one to look at the “Bulla Ethmoidalis” and “Middle Turbinate.” This chapter highlights these critical structures’ development, and presents in more detail their radiographic anatomy.

Key words

paranasal sinus computed axial tomography (CT) - frontal sinus drainage pathway - agger nasi - uncinate process - floor of the olfactory recess - lateral lamella - accessory air cells - bulla ethmoidalis - middle turbinate

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