Normal Variants: Paranasal Sinuses

Normal variants in the paranasal sinuses

Note listed are only the more common ones.
These are important in radiology report, as gives the endoscopist an idea what to look out for (Surgical planning).

Name	Location	Implication
Agger nasi cell	Ethmoid aircells. Located most anteriorly, infront of the cribriform plate where the middle turbinate attaches	If inflamed, patient may experience epiphora as it is close to the medial canthus	Agger nasi cell on the left side, just inferior to the frontal sinus
Haller cell (MaxilloEthmoidal cell, Infraorbital cell)	Aircells located along the margin of the orbital floor. Inferolateral to the ethmoidal bulla.	Presence of these cells may narrow the infundibulum and/or maxillary sinus ostium. Prone to obstruction and inflammation of the maxillary sinus.	Large right Haller cell
Onodi cell	Ethmoid aircells that extends into the sphenoid bone, located superior to the sphenoid sinus.	At risk of intracranial extension of the endoscope if surgeon (endoscopist) is not aware of the presence of Onodi cell.
Concha bullosa	Pneumatized middle turbinate. These cells usually communicates with the anterior ethmoid aircells.	Large concha bullosa enlarges the turbinate,  makes one prone to obstruction/ inflammation. Concha bullosa also makes endoscopic access more difficult.	Right concha bullosa. Notice the right middle turbinate is larger than the left (with absence of concha bullosa).

What normal variant(s) did you see here?