Anatomical Study of Frontal Recess and Ostium Via Cadaveric Dissection: Surgical Insights for Frontal Sinusotomy

Introduction: The frontal sinus is one of the most anatomically variable and surgically challenging regions of the paranasal sinuses. Precise understanding of frontal recess anatomy is essential for safe and effective frontal sinusotomy. This cadaveric study aims to evaluate key anatomical features of the frontal recess and ostium, providing clinically relevant data to enhance surgical outcomes. Methods: A descriptive anatomical study was conducted on 10 formalin-preserved, sagittally sectioned cadaveric heads in the Department of Anatomy and Otorhinolaryngology, Dayanand Medical College and Hospital, Ludhiana. Measurements were taken from the anterior nasal spine and the middle turbinate to the frontal sinus ostium using calibrated scales. The size and shape of the ostium were recorded, and patency was assessed with suction tips of varying diameters (3 mm, 4 mm, 5 mm). The presence of agger nasi cells was also noted. Results: The frontal sinus ostium was located 5.6–6 cm from the anterior nasal spine in 60% of specimens and 2.1–2.5 cm from the middle turbinate in 80%. The ostial diameter was predominantly between 3.6–4.0 mm (70%). Agger nasi cells were present in 80% of specimens. These findings correlate with previous cadaveric studies, reinforcing the anatomical variability of the region and the importance of key landmarks. Conclusion: This cadaveric analysis highlights essential anatomical considerations for frontal sinusotomy. The consistent presence of agger nasi cells and narrow frontal ostium dimensions underscore the technical demands of the procedure