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European Archives of Oto-Rhino-Laryngology

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01-11-2019 | Sinus Surgery | Rhinology

Incidence of anatomical variations according to the International Frontal Sinus Anatomy Classification (IFAC) and their coincidence with radiological sings of opacification

Authors: Fabian Sommer, Thomas Karl Hoffmann, Lena Harter, Johannes Döscher, Sebastian Kleiner, Jörg Lindemann, Andreas Leunig

Published in: European Archives of Oto-Rhino-Laryngology | Issue 11/2019

Abstract

Background

The endonasal access to the frontal recess and sinus may be complicated by a variety of anatomical variations. Previous classifications of these variants were characterized by proper names or position information without anatomical reference. The IFAC is intended to simplify the classification of anatomical variations of the frontoethmoidal complex. The aim of this study was to analyse a representative number of sinus CT scans to assess the incidence of anatomical variations according to the IFAC and to compare the results with previous classifications. In addition, the coincidence of complex anatomical variations and radiological sings of opacification was investigated.

Methodology/principal

Two hundred and forty-nine sinus CT scans were analysed in multiplanar reconstructions. Exclusion criteria were previous operations on the paranasal sinuses, malignant diseases, and an insufficient image quality. All anatomical variants were analysed according to the IFAC criteria. In addition, the coincidence of radiological sings of opacification and the presence of anatomical variations of the frontal recess and sinus were investigated.

Results

The analysis revealed Agger nasi cells in 95% of the CT scans. Supra agger cells (SACs) were detected in 49% and Supra agger frontal cells (SAFCs) in 25% of the data sets. Suprabulla cells (SBCs) were detected in 89% and Supra bulla frontal cells (SBFCs) in 27% of the scans. Supraorbital ethmoid cells (SECs) were detectable in 9% and interfrontal septal cells in 28% of the scans. Despite a partially strong narrowing of the frontal recess, no increased occurrence of radiological sings of opacification could be detected (p > 0.05).

Conclusions

Anatomical variations in the frontoethmoidal area are very common. According to the IFAC criteria, in 43% of the patients, cells could be detected with pneumatization to or into the frontal sinus. The IFAC is structured more clearly compared to previous classifications due to the anatomical aspect. It represents the most consistent classification regarding surgical planning. Further studies will demonstrate the scientific and clinical value of this classification.

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Title: Incidence of anatomical variations according to the International Frontal Sinus Anatomy Classification (IFAC) and their coincidence with radiological sings of opacification
Authors: Fabian Sommer
Thomas Karl Hoffmann
Lena Harter
Johannes Döscher
Sebastian Kleiner
Jörg Lindemann
Andreas Leunig
Publication date: 01-11-2019
Publisher: Springer Berlin Heidelberg
Keyword: Sinus Surgery
Published in: European Archives of Oto-Rhino-Laryngology / Issue 11/2019
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-019-05612-4

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Incidence of anatomical variations according to the International Frontal Sinus Anatomy Classification (IFAC) and their coincidence with radiological sings of opacification

Abstract

Background

Methodology/principal

Results

Conclusions

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Abstract

Background

Methodology/principal

Results

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