Finding the Frontal Sinus — The Agger Nasi Punch-Out-Procedure (POP)


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


  • 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/Things to Remember:

  • 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. By doing bone removal in the superior direction it does not destabilize the middle turbinate.

Reference: 2006-76 Agger Nasi Punch Out Procedure.pdf