Frequency of frontal cells according to the International Frontal Sinus Anatomy Classification

Abstract

Objectives: This study aims to determine the regional frequency of frontal cells classified by the International Frontal Sinus Anatomy Classification (IFAC) in local population radiologically. Patients and Methods: Between February 2018 and May 2019, a total of 300 frontal recess regions of 150 adults (88 males, 62 females; mean age 33.5±9.4 years; range, 18 to 54 years) eligible for the inclusion criteria and undergoing paranasal sinus (PNS) computed tomography (CT) were included in the study. In CT analysis; agger nasi cells, supra agger cells, supra agger frontal cell, suprabullar cells, suprabullar frontal cells, supraorbital ethmoid cells and frontal septal cells were evaluated. Results: For anteriorly based cells, there were agger nasi cells, supra agger cells, and supra agger frontal cells with rates of 94.3% (n=283), 40.0% (n=120), and 14.7% (n=44), respectively. For posteriorly based cells, there were suprabullar cells, suprabullar frontal cells, and supraorbital ethmoid cells with rates of 59.7% (n=179), 7.3% (n=22) and 7.3% (n=22), respectively. For medially based cells, there were frontal septal cells with a rate of 29.3% (n=44). Conclusion: Our study results suggest that the regional prevalence of frontal cells classified by the IFAC in Turkish population can be determined radiologically, providing contribution to the generation of estimates of the global prevalence of frontal cells.

Change of frontal sinus in age of according to the international frontal sinus anatomy classification

“…Much effort has been made to define and classify these cells, which have recently shown their effect on frontal sinus drainage, with IFAC describing the pneumatization pattern of the ethmoid and frontal sinuses (12,15). This classification system was developed as a clinical guide to provide a more anatomically accurate description of pneumatization patterns.…”

“…In a study on the clinical applicability and importance of IFAC, it has been reported that >65% of the residents included in the study found IFAC clinically applicable, and >70% saw it as a tool that helps in consistent communication between surgeons, and 65.6% agreed that it is necessary to understand the classification system. 15 However, it was emphasized that IFAC needs to be supported by intraoperative findings and should be studied with large samples (16,17).…”

“…Choby et al reported that agger nasi cells, suprabullar cells, supra agger cells, supraorbital ethmoid cells, supra agger frontal cells, and suprabullar frontal cells were detected at rates of 96.5%, 72.0%, 30.0%, 30.0%, 28.5%, and 20%, respectively, and reported that agger nasi cells were the most seen bilaterally (19). Başer et al, who evaluated frontal recess cells in adults according to IFAC, reported that agger nasi was found bilaterally in 91.3%, supra agger in 18.0%, supra agger frontal in 5.3%, and suprabullar cells in 41.3% (15). We determined that agger nasi cells were the cell groups with the highest prevalence bilaterally for age<18 years.…”

Anterior ethmoid and frontal sinus drainage pathways: five patterns formed and defined by their bony walls

“…The anatomy of the anterior ethmoid and frontal sinus is complex, but improvements in imaging technology are helping us to understand these spaces more clearly. Many recent reports have identified and classified the cells of the anterior ethmoid and frontal sinus based on their location [1][2][3][4][5]. However, the drainage pathways of the frontoethmoidal region are variable and their paths tortuous due to multiple bony walls which form the pathways.…”