Agger Nasi Punch-Out-Procedure (POP)

Running Time: 2:07

 Indications:

• Identification of frontal sinus ostium
• Removal of obstructed agger nasi cells

Highlights:

• Hajek punch used to remove face of frontal recess
• Agger nasi swept from posterior to anterior out of the frontal recess for removal 
• Identification and probing of the frontal sinus ostium

Keep in Mind:

• The advantage of this technique is that it allows direct visualization of the frontal recess with a zero-degree endoscope
• Bone removal should be in superior direction only so as not to destabilize the middle turbinate 

Reference: Agger Nasi Punch Out Procedure.pdf