Effects of Frontal Recess Cells on the Development of Frontal Sinusitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Frontal recess anatomy can be very complex, with accessory cells extending to the frontal sinus and possibly contributing to the obstruction of the frontal sinus. However, there is still controversy on the effect of the frontal recess cells. We designed this study to assess the effect of frontal recess cells on frontal sinusitis. SUBJECTS AND METHOD: We retrospectively reviewed chart and collected data of those who visited the outpatient clinic between January and June, 2011. Parnasal sinus CT was taken with Brillance 64-slice computed tomography scanners. The image was reviewed by two or more otolaryngologists to identify the frontal recess cells. The nasofrontal isthmus diameter and the area of nasofrontal isthmus was reconstructed and measured with workstation. Then, we compared the radiological results of frontal recess cells with the frequency of frontal sinusitis. RESULTS: The presence of anterior group of frontal recess cells showed no influence on the frontal recess anatomy. The presence of frontal bullar cell was significantly associated with the development of frontal sinusitis by simple (p=0.001) and multiple (p=0.038) logistic regression models. It was shown that the narrower the area of frontal isthmus the more developed were the frontal sinusitis, showing statistically significance in the simple (p=0.013) and multiple (p=0.017) logistic regression models. CONCLUSION: Our results also showed that similar results compared to previous Asianreport. The narrowness of nasofrontal isthmus could be the cause of frontal sinusitis. The frontal bullar cell could be the cause of frontal sinusitis encroaching on the frontal recess and affect the nasofrontal pathway.

Anatomic Variations of the Frontal Recess and Frontal Sinusitis: Computed Tomographic Analysis

BACKGROUND AND OBJECTIVES: The frontal recess (FR) cells, including the frontal cell (FC), agger nasi cell (ANC), supraorbital ethmoid cell (SOC) and inter-frontal sinus septal cell (IFSSC), can interfere with the drainage system of the frontal sinus. We evaluated the relationship between the FR cells and the frontal sinusitis. SUBJECTS AND METHODS: All paranasal sinus CT scans performed from July 2004 through June 2005 were reviewed. Of the 675 scans reviewed, 317 patients (634 sides) were selected for data collection. Exclusion criteria included a clinical history of neoplasms, bony deformities, and extensive disease responsible for obscuring the bony anatomy. Similarly, CT scans with severe artifacts were also excluded. RESULT: FCs were present in 21.9% of the patients. According to the Bent's classification, the prevalence of each FC type was as follows; type 1 FC (13.6%), type 2 FC (3.2%), type 3 FC (1.9%) and type 4 FC (3.1%). Of the four types of FR cells, type 4 had a significant association with frontal sinusitis. The incidence of hyperpneumatized frontal sinus, ANC, SOC, IFSSC were significantly higher among patients with the FC than those without the FC (p<0.05). Patients without the ANC or with type 1 uncinate process, according to Stammberger's classification, displayed a higher frequency of frontal sinusitis (p<0.05). There was a statistically significant decrease in the frequency of frontal sinusitis among patients with hypopneumatized frontal sinus (p<0.05). CONCLUSION: In our series, the frontal sinusitis was influenced by each types of FC, attachment sites of uncinate process and the degree of frontal sinus pneumatization. Therefore, these anatomic variations in the frontal recess should be appropriately addressed during the surgical management of the frontal sinusitis.

Prevalence of Frontal Recess Cells in Koreans / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: This research aimed to evaluate the prevalence of specific frontal recess cells in Koreans using the classification developed by Lee, et al. SUBJECTS AND METHOD: Frontal recess was studied using high resolution CT scans of normal 60 Koreans. RESULTS: Three volunteers were found to have sinusitis around frontal recess in CT and therefore were excluded from this study. Agger nasi cells were observed in 107 sides (94.0%), frontal cell type 1 in 26 sides (22.8%), type 2 in 16 sides (14,0%), type 3 in 9 sides (7.9%) and type 4 in 0 side (0.0%). Frontal bullar cells were observed in 16 sides (14.0%), suprabullar cells in 45 sides (39.5%) and supraorbital ethmoid cells in 3 sides (2.6%). Intersinus septal cells were observed in 10 sides (8.8%) and terminal recess in 76 sides (66.7%). CONCLUSION: This is the first study conducted about the Korean prevalence of frontal recess cells using the new classification.

The distributional characteristics of frontal recess cells during image navigation assisted endoscopic sinus surgery / 中国耳鼻咽喉头颈外科

OBJECTIVE To recognize the frontal recess cells and analyze their distributional characteristics during image navigation assisted endoscopic sinus surgery. METHODS 20 cases(39 sides)of chronic sinusitis with nasal polyps were observed in this study. The fontal recess cells and frontal sinus were opened under the endoscope and the distributional characteristics were observed and recorded, and then confirmed by the image navigation system. RESULTS Centred on frontal sinus ostium, frontal recess cells were divided into three areas: the agger nasi cell(ANC)and frontal cells(FC)are located in front of frontal sinus ostium(FS); frontal septum cells(IFSSC)and terminal cells(RT)are located at the same plane of FS; supra-ethmoidal bulla recess(SBR), frontal bulla cell(FBC)and super-obital cells(SOEC)are in the posterior area. The coincidence of identification for ANC, FCI and II, SBR, FBC and IFSSC under endoscope and image navigation is 100%, the coincidence of identification for FS is 89.7%, SOEC 80%, RT 71.4% and FC III and IV 60%. CONCLUSION The distribution of the frontal recess cells around the frontal ostium showed a fixed pattern.It would well benefit the orientation of frontal ostium and the opening of frontal sinus. Furthermore, it is significant for the orientation and opening of the frontal recess cells.