Abstract
BackgroundComprehensive understanding of frontal recess anatomy is essential for the successful treatment of patients with frontal sinus disease. This study was designed to determine the prevalence of specific frontal recess cells in Japanese subjects and the association of these cells with the development of frontal sinusitis.MethodsFrontal recess anatomy was analyzed using high-resolution spiral computed tomography images of paranasal sinuses from December 2008 through September 2011. The distribution of various frontal recess cells in patients with and without frontal sinusitis was compared by logistic regression analysis.ResultsA total of 150 patients met the criteria, and 300 sides were analyzed. Agger nasi cells were present in 88.0 % of sides; frontal cell types 1 (FC1), 2 (FC2), 3 (FC3), and 4 (FC4) were present in 37.0 %, 6.3 %, 4.3 %, and 1.3 %, respectively; supraorbital ethmoid cells in 6.0 %, suprabullar cells in 37.0 %, frontal bullar cells (FBC) in 7.0 %, and interfrontal sinus septal cells in 8.6 %. Multiple logistic regression analysis showed that the presence of FBCs was significantly associated with the development of frontal sinusitis (p = 0.043).ConclusionsThe frequencies of frontal recess cells in Japanese adult patients were similar to those reported for other East Asian adult populations, including Chinese, Korean, and Taiwanese. Anatomically, FBCs may show a greater association with the development of frontal sinusitis than other frontal recess cells.
Highlights
Comprehensive understanding of frontal recess anatomy is essential for the successful treatment of patients with frontal sinus disease
Frontal recess cells consist of a combination of cells, including agger nasi cells (ANCs), frontal cell types (FCs) 1 to 4, suprabullar cells (SBCs), supraorbital ethmoid cells (SOECs), frontal bullar cells (FBCs), and intersinus septal cells (IFSSCs) [1]
In categorizing frontal recess cells, we found ANCs in 265 sides (88.0 %) and FCs in 147 (49.0 %), with frontal cell types 1 (FC1) in 111 sides (37.0 %), FC2s in 19 sides (6.3 %), FC3s in 13 sides (4.3 %), and FC4s in four sides (1.3 %)
Summary
Comprehensive understanding of frontal recess anatomy is essential for the successful treatment of patients with frontal sinus disease. This study was designed to determine the prevalence of specific frontal recess cells in Japanese subjects and the association of these cells with the development of frontal sinusitis. The variable frontal recess cells in each patient must be analyzed to plan a strategy for dissecting all cells disturbing the nasofrontal recess, including drainage of the frontal sinus. This study used high-resolution CT images to analyze Japanese patients with frontal sinusitis. We hypothesized that Stammberger’s theory may apply to the development of frontal sinusitis, and paid particular attention to FC3s, FC4s, SBCs, SOECs, and FBCs, which can narrow the ventilation pathway of the frontal sinus. The purpose of this study was to clarify the association of various frontal
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