Anatomy of Frontal Recess and Opening

The boundaries of the frontal recess are typically formed by the agger nasi cell anteriorly; the lamina papyracea laterally; the most anterior and superior portion of the middle turbinate medially; and the ethmoid bulla, its associated bulla lamella, and the suprabullar cell (if present) posteriorly. This area is called the frontal recess. This is one of the most common regions for residual infection after sinus surgery. Special instruments and training are needed to adequately address obstructions here. Even when special care is taken to examine and protect this area, frontal sinus obstruction can be difficult to correct. The frontal sinus has the longest drainage pathway. Surprisingly, the frontal sinus is not as frequently involved as the maxillary or anterior ethmoid sinuses (Figure 2).