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

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/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