E1362. What’s Up Front? An Educational Guide About the Frontal Recess for Residents
  1. Kristina Jones; UAMS
  2. Memoona Mian ; UAMS
  3. Prashanth Reddy; UAMS
  4. Surjith Vattoth; UAMS
Sinus disease has a marked worldwide prevalence and a large economic burden. Functional endoscopic sinus surgery (FESS) is usually indicated in patients with chronic sinus disease that persists despite aggressive medical therapy. Preoperative computed tomography (CT) imaging prior to FESS is necessary to evaluate patient’s sinus anatomy and highlight any variants, which can impact the success of surgery. Residents typically lack education on the basic anatomy of the frontal recess (FR) and adjacent structures. An educational anatomical guide for residents that simplifies the anatomy of the frontal recess and related air cells would not only introduce an unfamiliar topic but also teach residents how to best assess preoperative CT images for a surgeon’s yield.

Educational Goals / Teaching Points
Educate radiology and ENT residents on normal anatomy of the FR and common anatomical variants. Introduce necessary basic knowledge about frontal recess surgeries to learn how to better interpret images from the ENT surgeon’s point of view.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This exhibit targets simplifying FR anatomy to make it easily understood by residents. It highlights normal anatomy and common variants and also notes the important structures anterior to the FR, which are the Agger nasi and Kuhn cells and posterior to the FR, which are the ethmoid bulla, suprabullar cell, frontal bullar cell, and anterior ethmoid artery. It will use simplified illustrations and corresponding CT images to introduce FR anatomy and common variants. It will briefly outline FR surgeries performed by otolaryngologists and how to best assess CT images to assist with operative planning.

Knowledge of frontal recess anatomy and common variants is crucial because it can directly result in an incomplete or failed FESS in the FR.