International Frontal Sinus Anatomy Classification and Anatomic Predictors of Low-Lying Anterior Ethmoidal Arteries

Sjogren, Phayvanh P.; Waghela, Rajendra; Ashby, Shaelene; Wiggins, Richard H.; Orlandi, Richard R.; Alt, Jeremiah A.

doi:10.2500/ajra.2017.31.4428

Cited by 15 publications

(10 citation statements)

References 14 publications

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“…In the current study, we determined the prevalence, symmetry, and interrater agreement of IFAC cell types in an adult population with non-diseased sinuses. To date, a few studies have documented the prevalence of FR cells using the IFAC in different populations with healthy sinuses [2,3,10,12,13]. The most frequently observed FR cell in our study was ANC, present in 88% of sides, consistent with previous literature quoting ANC incidence between 87-97%.…”

Section: Discussionsupporting

confidence: 90%

Computed Tomographic Analysis of Frontal Recess Cell Prevalence According to International Frontal Sinus Anatomy Classification

Yaylacı

Değer

2023

Preprint

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Purpose The frontal recess (FR) has a complex anatomy composed of a number of cells that dictate the frontal sinus drainage pathway. The International Frontal Sinus Anatomy Classification (IFAC) is a new system for classifying FR cells. This study investigated the prevalence and symmetry of IFAC cells in healthy sinuses and assessed the interrater agreement of IFAC cells. Methods 509 adult patients with non-diseased paranasal sinuses were included in this retrospective cross-sectional study. Two rhinologists independently identified IFAC cells on 1018 sides using triplanar CT reconstructions. The prevalence of each cell type was assessed, and interobserver agreement was measured using the kappa coefficient (κ). Results The prevalence of FR cells varied, with the agger nasi cell (ANC) being the most prevalent at 88.0% and the supra bulla frontal cell (SBFC) being the least prevalent at 7.1%. FR cells that pneumatize into the frontal sinus were identified in 28.6% of the FRs, with male patients having a significantly higher prevalence than female patients. The ANC had the highest bilateral incidence at 80.4%, while the SBFC had the lowest at 2.2%. All IFAC cells had excellent interrater agreement, with κ values ranging from 0.94 to 1.0. Conclusion The prevalence of FR cells varies among populations. Male patients were more likely to have FR cells that pneumatize across the frontal sinus. These results highlight the importance of considering population- and gender- specific prevalence rates of individual FR cells in endoscopic sinus surgery planning. IFAC is a reliable tool for identifying cells in the FR with a high level of interrater agreement.

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Section: Discussionsupporting

confidence: 90%

Computed Tomographic Analysis of Frontal Recess Cell Prevalence According to International Frontal Sinus Anatomy Classification

Yaylacı

Değer

2023

Preprint

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“…Additionally, although they were unilateral, the agger nasi cells were seen in the study performed by Choby et al, [19] and the agger nasi cells were not seen bilaterally in four patients of our study. Also, in the study performed by Sjogren et al, [20] similar to our study, the most common IFAC cell types were found as follows: agger nasi cells, suprabullar cells, and supra agger cells with rates of 88.9%, 55.8%, and 29.5%, respectively. They found the supraorbital ethmoid cells to be the rarest cell type with a rate of 11.6%.…”

Section: Discussionsupporting

confidence: 90%

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

Başer¹,

Sarıoğlu²,

Bulut³

et al. 2020

tr-ent

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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.

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“…This study found a positive correlation between FSV and OFD. Previous studies supported these findings and reported, stating that individuals with a hyper aerated FS seem to be more prone to the risk of complication 5 , 6 , 18 . During the skull base surgery, the LL as the thinnest part of the skull base is a common risk site 16 .…”

Section: Discussionsupporting

confidence: 62%

“…Because of the anatomical proximity of the frontal sinus to the orbit and anterior skull base, neurosurgeons must consider this when performing supraorbital craniotomy 17 . Previous research has suggested that an increase in OFD may be associated to a higher risk of complications 18 . This study found a positive correlation between FSV and OFD.…”

Section: Discussionmentioning

confidence: 95%

The Relation Between the Metopic Suture Persistence and Frontal Sinus Volume and Olfactory Fossa Depth: A Reliability Study with Semiautomatic Volume Measurement

Atalay¹,

Eser²

2021

MMJ

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Objective: This study aims to investigate the relationship of the persistence of metopic suture (PMS), frontal sinus volume (FSV), and olfactory fossa depth (OFD). Methods: Tomography scans of 1,603 patients aged 18-65 years were evaluated for the presence of PMS. In the study, 74 PMS cases and 74 controls were included. The appearance of each individual’s frontal sinus was classified as aplasia, hypoplasia, or normal. Two observers independently measured the lateral lamella length (LLL), OFD, and FSV. Interobserver agreement was evaluated with the intraclass correlation coefficient (ICC) and Cohen’s kappa coefficient (κ). Results: The prevalence of PMS was found to be 4.99% [95% confidence interval (CI): 4.03-6.17]. The PMS group had five times higher hypoplasia/aplasia than the controls (52.70%, 95% CI: 41.48-63.66 and 10.81%, 95% CI: 5.58-19.91, respectively; p<0.001). An “almost perfect” agreement was detected among observers for the frontal sinus appearance classification: κ=0.807, p<0.001. The ICC of continuous measurements for OFD, LLL, and FSV, respectively, presented “excellent” reliability: 0.956, 0.958, and 0.981, with p<0.001 for each. LLL was shorter, OFD was shallower, and FSV was smaller in the PMS group than the control group (p<0.001). There was a moderate positive correlation between OFD, LLL, and FSV (r=0.306, r=0.302). Conclusions: This study interprets that the presence of PMS is related frontal sinus development and volume. With PMS, a smaller FS, shorter lateral lamella, and shallower olfactory fossa may be expected.

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International Frontal Sinus Anatomy Classification and Anatomic Predictors of Low-Lying Anterior Ethmoidal Arteries

Cited by 15 publications

References 14 publications

Computed Tomographic Analysis of Frontal Recess Cell Prevalence According to International Frontal Sinus Anatomy Classification

Computed Tomographic Analysis of Frontal Recess Cell Prevalence According to International Frontal Sinus Anatomy Classification

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

The Relation Between the Metopic Suture Persistence and Frontal Sinus Volume and Olfactory Fossa Depth: A Reliability Study with Semiautomatic Volume Measurement

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