Meticulous anatomical knowledge is mandatory to approach endoscopically the frontal sinus area safely and manage its diseases successfully. The aim of this study was to identify the various drainage patterns of the frontal sinus. To illustrate these patterns we performed anatomical dissections of the outflow tract of the frontal sinus in 30 cadaver half heads. We found that the frontal sinus drained anterior to the uncinate process in 23.3% of specimens and posterior to it in 63.3%, while it drained medial to the semilunar hiatus in 6.6%. Our study, however, represents an exclusive assortment of linear and angular measurements of important landmarks around the frontal recess region. Although these measurements were made in embalmed tissue, we believe they will provide reference points in endoscopic sinus surgery.

While elbow dislocation is a common occurrence, the vast majority of them dislocate posteriorly and are due to disruption of the elbow stabilizers, which start on the lateral side and proceed medially, disrupting the anterior and posterior stabilizing structures. We present an unusual case of anterior elbow dislocation, with disruption of the medial stabilizing structures and anterior capsule, without any bony injury. A 44-year-old man presented to the ED after being assaulted. While the exact mechanism of injury was unclear, the patient believes he had been struck with a heavy object on the posterior aspect of his elbow. His dislocation was reduced in the ED, but was highly unstable after reduction. Further imaging revealed disruption of his medial collateral ligaments and common flexor origin. He went on to have an open repair of his medial structures with suture anchors. After six weeks of follow-up he was doing well, with no further episodes of instability and a good functional range of movement. Though rare, anterior elbow dislocations have been reported sporadically in the literature. Surgeons and ED doctors dealing with these injuries should be aware that the maneuvers to relocate the elbow will be different compared to the standard maneuvers used for posterior dislocations. Patients should be examined for stability after reduction, especially on valgus stressing. We would advocate for low threshold for performing an examination under anesthesia (EUA), with open repair of the stabilizing structures if persistently unstable after reduction.