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Indian Journal of Otolaryngology and Head & Neck Surgery

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01-09-2023 | Frontal Sinusitis | Original Article

A Prospective Study on the Anatomical Variations of the Frontal Recess and its Association with Computer Tomographic Signs of Sinusitis

Authors: Snigdha Girish Koliyote, Rohit Singh, Neethu Mary Mathew, Prakashini K

Published in: Indian Journal of Otolaryngology and Head & Neck Surgery | Issue 1/2024

Abstract

The frontal recess region has a complex anatomy and HRCT scans of the paranasal sinuses (PNS) are the gold standard in evaluating it. Classification systems have been established to identify the frontal recess cells. The objectives of this study are to describe the incidence of anatomical variations, classify the anatomy of the frontal recess using the IFAC & Kuhn’s classification systems, find the association between the anatomical variations and the incidence of CT signs of sinusitis.

A prospective study of patients undergoing HRCT-PNS was carried out. The frontal recess region was evaluated and classified as per both classification systems. The prevalence of each frontal cell was identified; presence of CT signs of sinusitis was noted and the correlation between the two was evaluated. 272 sides of HRCT scans were evaluated.

Prevalence of cells as per IFAC classification showed ANC - 98.2%, SAC-43.4%, SBC-33.1%, SAFC- 28.3%, FSC -25%, SBFC- 3.7% and SOEC- 2.2%. Prevalence of cells as per Kuhn’s classification showed ANC - 98.2%, Type 1- 38.2%, SBC-32.7%, FSC -24.3%, Type 3- 16.9%, Type 2- 12.9%, Type 4- 4.8%, FBC- 2.6% and SOEC-2.2%. Sinusitis was seen in 27.2% cases. A significant association was noted between the presence of SOEC, FSC and sinusitis as per both classification systems. (P=0.049 and P<0.001 respectively).

In conclusion the cells which lead to an anteriorly based drainage pathway are more common, but the presence of posteriorly based SOEC and medially based FSC have a higher association with sinusitis.

Bent JP, Guilty-Siller G, Kuhn FA (1994) “The Frontal Cell As a Cause of Frontal Sinus Obstruction,”

Lee WT, Kuhn FA, Citardi MJ (Sep. 2004) 3D computed tomographic analysis of frontal recess anatomy in patients without frontal sinusitis. Otolaryngol - Head Neck Surg 131(3):164–173. https://doi.org/10.1016/j.otohns.2004.04.012

Wormald PJ et al (Jul. 2016) The International Frontal Sinus anatomy classification (IFAC) and classification of the extent of endoscopic frontal sinus surgery (EFSS). Int Forum Allergy Rhinol 6(7):677–696. https://doi.org/10.1002/alr.21738

Van Alyea OE, “FRONTAL CELLS AN ANATOMIC STUDY OF THESE CELLS WITH CONSIDERATION OF THEIR CLINICAL SIGNIFICANCE (1941),” [Online]. Available: http://archotol.jamanetwork.com/

DelGaudio JM, Hudgins PA, Venkatraman G, Beningfield A (2005) Multiplanar Computed Tomographic Analysis of Frontal Recess cells. Arch Otolaryngol Neck Surg 131(3):230. https://doi.org/10.1001/archotol.131.3.230CrossRef

Tuncyurek O, Songu M, Adibelli ZH, Onal K (2012) Frontal infundibular cells: pathway to the frontal sinus. Ear Nose Throat J 91(3):29–32. https://doi.org/10.1177/014556131209100319CrossRef

Eweiss AZ, Khalil HS (2013) “The Prevalence of Frontal Cells and Their Relation to Frontal Sinusitis: A Radiological Study of the Frontal Recess Area,” ISRN Otolaryngol., vol. pp. 1–4, 2013, https://doi.org/10.1155/2013/687582

Wang P et al (2016) Study of frontal recess anatomy based on three-dimension computed tomography images reconstruction in chinese subjects without frontal sinus disease. Int J Clin Exp Med 9(10):18912–18920ADS

Kubota K, Takeno S, Hirakawa K (2015) Frontal recess anatomy in japanese subjects and its effect on the development of frontal sinusitis: computed tomography analysis. J Otolaryngol - Head Neck Surg 44(1). https://doi.org/10.1186/s40463-015-0074-6

10.

Sagar GRS, Jha BC, Meghanadh KR (2013) A study of anatomy of frontal recess in patients suffering from ‘Chronic frontal sinus disease’. Indian J Otolaryngol Head Neck Surg 65(SUPPL2):435–439. https://doi.org/10.1007/s12070-013-0653-7CrossRefPubMedPubMedCentral

11.

Tran LV, Ngo NH, Psaltis AJ (2019) “A Radiological Study Assessing the Prevalence of Frontal Recess Cells and the Most Common Frontal Sinus Drainage Pathways,” Am. J. Rhinol. allergy, vol. 33, no. 3, pp. 323–330, Feb. https://doi.org/10.1177/1945892419826228

12.

Pham HK, Tran TT, Van Nguyen T, Thai TT (2021) Multiplanar Computed Tomographic Analysis of Frontal cells according to International Frontal Sinus anatomy classification and their relation to Frontal Sinusitis. ” Rep Med Imaging 14:1–7. https://doi.org/10.2147/RMI.S291339CrossRef

13.

Choby G, Thamboo A, Bin Won T, Kim J, Shih LC, Hwang PH (2018) “Computed tomography analysis of frontal cell prevalence according to the International Frontal Sinus Anatomy Classification,” Int. Forum Allergy Rhinol., vol. 8, no. 7, pp. 825–830, Jul. https://doi.org/10.1002/alr.22105

14.

Sommer F et al (2019) “Incidence of anatomical variations according to the International Frontal Sinus Anatomy Classification (IFAC) and their coincidence with radiological sings of opacification,” Eur. Arch. Oto-Rhino-Laryngology, vol. 276, no. 11, pp. 3139–3146, https://doi.org/10.1007/s00405-019-05612-4

15.

Gotlib T, Kołodziejczyk P, Kuźmińska M, Bobecka-Wesołowska K, Niemczyk K (2019) “Three-dimensional computed tomography analysis of frontoethmoidal cells: A critical evaluation of the International Frontal Sinus Anatomy Classification (IFAC),” Clin. Otolaryngol., vol. 44, no. 6, pp. 954–960, Nov. https://doi.org/10.1111/coa.13412

16.

NEA F, NM L, A. ME MZW, Abdullah B (2022) “The prevalence of frontal cell variants according to the International Frontal Sinus Anatomy Classification and their associations with frontal sinusitis.,” European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, vol. 279, no. 2. pp. 765–771, https://doi.org/10.1007/s00405-021-06843-0

17.

Seth N, Kumar J, Garg A, Singh I, Meher R (2020) “Computed tomographic analysis of the prevalence of International Frontal Sinus Anatomy Classification cells and their association with frontal sinusitis,” J. Laryngol. Otol., vol. 134, no. 10, pp. 887–894, Oct. https://doi.org/10.1017/S0022215120002066

18.

Villarreal R et al (Jan. 2019) International assessment of inter- and intrarater reliability of the International Frontal Sinus anatomy classification system. Int Forum Allergy Rhinol 9(1):39–45. https://doi.org/10.1002/ALR.22200

19.

Assiri K, Alroqi A, Aldrees T, Almatrafi S (2020) Assessment of International Frontal Sinus anatomy classification among senior residents through inter- and intra-rater reliability. SAUDI Med J 41(5):466–466. https://doi.org/10.15537/smj.2020.5.25071CrossRefPubMedPubMedCentral

Title: A Prospective Study on the Anatomical Variations of the Frontal Recess and its Association with Computer Tomographic Signs of Sinusitis
Authors: Snigdha Girish Koliyote
Rohit Singh
Neethu Mary Mathew
Prakashini K
Publication date: 01-09-2023
Publisher: Springer India
Keyword: Frontal Sinusitis
Published in: Indian Journal of Otolaryngology and Head & Neck Surgery / Issue 1/2024
Print ISSN: 2231-3796
Electronic ISSN: 0973-7707
DOI: https://doi.org/10.1007/s12070-023-04193-3

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A Prospective Study on the Anatomical Variations of the Frontal Recess and its Association with Computer Tomographic Signs of Sinusitis

Abstract

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