COMPARATIVE TOMOGRAPHIC ANALYSIS OF THE FRONTAL BEAK AND ITS CORRELATIONS

Abstract

Introduction: The frontal sinus has a complex and varied anatomy, being considered challenging in the nasosinusal surgical approach. Tomographic anatomical landmarks, such as the frontal beak (FB), are essential for understanding and planning strategies for the treatment of this region. Objective: to investigate tomographic measurements of the FB and its correlations, focusing on the angle formed between the FB, columella and frontal sinus ostium (FCO). Methods: Retrospective and analytical study, based on the review of medical records of computed tomography scans of the paranasal sinuses, independently evaluated by two otolaryngologists. Divergent data were reassessed by a third experienced surgeon. The data were statistically analyzed. Results: CT scans of 50 patients aged 19 to 73 years were studied, totaling 100 images. Columella-FB distance and FB thickness were higher in men (p≤0.001); the size of the frontal ostium (FOD) was smaller the greater the number of frontal cells (p=0.012) and FCO angle (p=0.003); the FCO angle varied according to the position of the FB (FOG) (p<0.001), level of surgical difficulty (p<0.001) and columella-FB distance (p=0.017); the most prevalent frontal cell was the agger nasi (97%). Discussion: Thickness and location of the FB, as well as FOD, are known to be related to the difficulty of surgical access to the frontal recess, and the FCO angle showed a significant correlation with the measures studied. Conclusion: The frontal beak is a constant structure, which measurements and correlations, such as the FCO angle, can configure an auxiliary tool for the otolaryngologist and serve as basis for future studies.