Korean J Otolaryngol-Head Neck Surg.  2004 Aug;47(8):751-755.

Frontal Sinusitis Related to Anatomic Variations

Affiliations
  • 1Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Hallym University, Seoul, Korea. pecdean@hanafos.com

Abstract

BACKGROUND AND OBJECTIVES
The frontal recess is the drainage pathway for the frontal sinus and its boundaries are formed by adjacent structures: they include agger nasi (anterior wall), medial orbital wall (lateral wall), ethmoid bulla/agger nasi (lateral wall), ground lamella (posterior wall), and anterior ethmoid air cells (posterosuperior). It is known that the drainage of the frontal recess is influenced by anatomic variants (agger nasi cell, frontal cells, supraorbital cell, intersinus septal cell, and attachment type of uncinate process). Because of its complex anatomy, the frontal sinus has been a difficult area in which to obtain consistently good long-term surgical results. SUBJECTIVES AND METHOD: To show the prevalence of anatomic variants and the relationship between the variants and frontal sinusitis, we analyzed the coronal and axial computed tomography of 225 patients, and 450 side sinuses (from 2001-6-1 to 2002-12-31). RESULTS: Frontal cells are observed in 176 cases (40.1%), agger nasi cell in 380 cases (84.8%), supraorbital cell in 17 cases (3.8%), and intersinus septal cell in 19 cases (11%). In the attachment type of the uncinate process, the lamellar type was seen in 272 cases (60.2%), the skull base type in 171 cases (26%), and the middle turbinate type in 62 cases (13.8%). The frontal sinusitis were seen in 8 cases (88.9%) among the type IV frontal cell group (9 cases) and in 149 cases (39.1%) among the agger nasi group. CONCLUSION: Relatively higher prevalence of anatomic variants was seen. The type IV frontal cells and agger nasi cells were significantly related to the frontal sinusitis.

Keyword

Frontal sinus; Sinusitis; Anatomy
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