Chronic Frontal Sinusitis Research Articles

Using computed tomography to diagnose chronic frontal sinusitis in the skeletal remains of a post-medieval Dutch rural community (AD 1829–1866)

Chronic frontal sinusitis (CFS) has afflicted humanity throughout history and continues to be a significant global health issue today. In bioarchaeology, sinusitis is often diagnosed through the identification of bone alterations within the maxillary sinus cavities by macroscopic and/or endoscopic examination. However, due to the inaccessible nature of frontal sinuses, CFS specifically has not been studied extensively archaeologically yet. This paper aims to demonstrate the effectiveness of diagnosing CFS through computed tomography (CT), highlighting the potential of radiographical imaging for future advancements in paleopathological research.We conducted a CT examination of 41 crania from the rural community of Middenbeemster, the Netherlands (AD 1829–1866) to assess the presence of CFS. Criteria for identifying CFS included bone formation and/or thickening of the sinus walls. Our analysis revealed that 14 individuals (34.1%) exhibited signs of CFS in one or both frontal sinuses. We found that males exhibited a slightly higher CFS prevalence (38%) than females (32%), although no significant correlation between sex and sinusitis occurrence was found. This lack of correlation suggests equal exposure to risk factors (e.g., indoor air quality, environmental pollution, allergens, and cold weather) among both sexes.To our knowledge, this study is the first of its kind to confirm the presence of CFS through CT scanning in an archaeological skeletal collection. It demonstrates that computed tomography allows for a straightforward and non-destructive detection of sinusitis in archaeological assemblages. Considering the currently limited bioarchaeological research on frontal sinusitis, our findings should be considered relevant and promising for future osteoarcheological studies on upper respiratory diseases.

Clinical and Anthropological Analyses of a Case From 19th Century South Africa With a Confluence of Uncommon Cranial Pathological Conditions.

This study combines clinical and anthropological analyses to investigate the complex cranial pathology of a South African individual from the 19th century. The cranium was examined macroscopically and radiographically. Conducting a standard differential diagnosis was challenging given the complexity and uncommon nature of the pathology and required drawing on relatively sparse paleopathological and clinical case reports. Multiple conditions were identified including biparietal thinning, basilar invagination, platybasia, and complicated chronic frontal sinusitis, where the intracranial extension of sinus infection may likely have contributed to the individual's death. The authors urge for awareness of these uncommon conditions, as their presence can easily be overlooked or confound skeletal assessments. This clinical study contributes to the authors' understanding of uncommon and poorly described paleopathological diseases and will help to better facilitate their diagnosis in future research. It represents one of the first studies describing such an unusual cooccurrence of uncommon pathologies in an archeological individual.

Silent sinus syndrome with interfrontal sinus retraction: A 3-case series using CARE methodology

IntroductionSilent sinus syndrome (SSS) is a rare entity, almost exclusively involving the maxillary sinus, frontal location being very rarely reported. The aim of the present study was to describe clinical and radiological characteristics and surgical treatment using the CARE methodology. ResultsOne woman and 2 men were referred for chronic unilateral frontal pain with imagery showing silent sinus syndrome. All showed partial or complete liquid opacification of the affected sinus associated with a thin interfrontal sinus (IFS) retracted toward the affected sinus. Functional endoscopic sinus surgery was performed in all cases, with good functional results. DiscussionWe describe 3 cases of SSS with IFS involvement. The frontal sinus wall seemed most vulnerable, probably most liable to be weakened by atelectasis. The study suggests that frontal SSS can be an etiology in chronic frontal sinusitis. Preoperative findings of IFS retraction are useful for surgical restoration of frontal sinus ventilation, relieving chronic pain and preventing complications.

The value of frontal sinusotomy in cases of sinonasal polyposis

BackgroundChronic frontal sinusitis is being treated with less invasive transnasal endoscopic treatments. Surgery relieves illness and prevents recurrence. Our study was conducted on 80 patients who suffer from frontal opacity with sinonasal polyposis and divided randomly into 2 groups: group A: 40 patients candidate for anterior ethmoidectomy without identification of frontal sinus ostium and group B: 40 patients candidate for anterior ethmoidectomy with identification of frontal sinus ostium. The study was conducted in the otolaryngology department faculty of medicine Cairo university.ResultsCT score and sinonasal endoscopy score were statistically significantly improved postoperatively compared to preoperative scores in both groups. There are no significant differences between the 2 groups regarding recurrence rate and complications.ConclusionEthmoidectomy without frontal sinusotomy is a potential substitute for frontal sinusotomy for the treatment of chronic frontal sinusitis with sinonasal polyposis, and it can achieve similar improvements in symptoms and radiological evidence of frontal sinusitis.

The efficacy of the extended endoscopic frontal sinus drill-out in cases of repeatedly operated polypous-purulent pansinusitis accompanied by a whistle in the front wall of the frontal sinus

Treatment of patients with severe chronic and recurrent forms of frontal sinusitis, often caused by scarring as a result of repeated interventions in the frontal sinuses, is a difficult task. In such cases, for adequate drainage of the frontal sinus and ensuring stable patency of the nasolabial anastomosis, an endoscopic extended frontotomy can be the choice operation, the possibility of which certainly depends on the experience of the surgeon, anatomical features of the structure of the frontal sinus and the nature of the pathological process. The article shows the effectiveness of surgical treatment of chronic purulent frontal sinusitis that developed after 5 interventions on the paranasal sinuses with external and combined access, accompanied by the development of a fistulous passage of the anterior wall of the frontal sinus. For wide drainage of the frontal sinus and stable preservation of patency of the nasolabial fistula, the patient underwent extended endoscopic frontotomy (Draf III operation according to the international classification).

Long-term results of extended endoscopic interventions in severe forms of chronic frontal sinusitis

Long-term results of extended endoscopic interventions in severe forms of chronic frontal sinusitis

Extended endoscopic frontal nasal sinus surgery in management of chronic and recurrent frontal sinus diseases

BackgroundThe anatomical variation of the frontal sinus and its intimate relation to the skull base and orbit makes its surgery demanding. The extended endoscopic frontal sinus surgery allows wide better drainage and preventing the recurrence of the disease. Fourteen patients underwent EEFSS from May 2017 to May 2019. These patients are nine patients presented by chronic recurrent frontal sinusitis, three patients presented by chronic recurrent fronto ethmoidal mucocele and two patients with chronic recurrent external frontal fistula. Draff III done for ten patients of them and Draff IIB done for four patients of them. This study is designed for evaluating the efficacy of the extended endoscopic frontal sinus surgery (E E F S S) in management of chronic and recurrent frontal sinus diseases.ResultsThe neo opening of the restored frontal sinus was remained opened with Draff III with high success rate; two patients from four patients with Draff IIb were with closed nasofrontal duct. The main follow-up was 12 months; the patients were followed up post-operatively for many office visits without any other manifestations.ConclusionThe chronic recurrent frontal sinus diseases can be treated successfully with extended endoscopic frontal sinus surgery (E E F S S). The extended endoscopic frontal sinus surgery (Draff III) provides good results with low morbidity and less post-operative care.

The prognostic variables affecting the frontal sinusotomy patency outcome and how to manage: A prospective study.

The study aimed to assess the factors affecting the frontal sinus patency after endoscopic frontal sinusotomy. A prospective cohort study. Tertiary centre hospital. Fifty patients with refractory chronic frontal sinusitis (83 operated frontal sinuses) had frontal sinusotomy and followed up for six months. Multiple operative factors were included the type of the procedure, intraoperative sinus findings, degree of mucosal preservation and middle turbinate stability. Other factors were also assessed, including smoking, the presence of allergic rhinitis, asthma, gastroesophageal reflux and other associated medical comorbidities. The sinus patency success rate was 75.9%. There was a significant difference regarding the intraoperative anteroposterior sinus ostium diameter (5.36±1.45mm vs 8.88±2.38mm, P-value: .001* in the failed group and the success group, respectively). There was a significant association between the patency outcome and the presence of associated medical comorbidities (P-value: .001*), the presence of allergic rhinitis (P-value: .001*), the degree of sinus mucosal preservation (P-value: .012*) and the degree of middle turbinate stability (P-value: .001*). The multivariate analysis showed that the intraoperative anteroposterior diameter of the sinus ostium, middle turbinate stability and presence of allergic rhinitis were significant predictors (P-value: .012*, .042* and .013*, respectively). Sinuses with anteroposterior ostium diameters less than 5.36mm are more susceptible to restenosis. The flail middle turbinate increases the risk of postoperative middle meatus synechia and frontal sinus patency failure. The presence of allergic rhinitis has a negative impact on the patency outcome.

The impact of bolgerization versus partial resection of the middle turbinate on frontal sinusotomy patency outcome: A randomised controlled study.

This study aimed to compare the effects of middle turbinate resection vs bolgerization on the incidence of middle meatus synechia and their prognostic value on the patency outcomes after frontal sinusotomy. A randomised controlled study. Tertiary centre hospital. Thirty-eight patients undergoing bilateral frontal sinusotomy for chronic frontal sinusitis were included. Partial middle turbinate resection was alternated with bolgerization in both nasal cavities of every patient. The Lund-Kennedy endoscopic scores (LKESs) for both sides were compared at the first, third and sixth months postoperatively. Middle meatus synechia was assessed using the visual analogue score (VAS). Sinus patency was assessed at the end of the sixth month using a 70° nasal endoscope. The sinus patency outcome was significantly higher in the resected group (34\38) than the bolgerized group (26\38), (P=.047*). The VAS scores suggested that the middle turbinate bolgerization group showed a significantly higher incidence of middle meatal synechia than the partial middle turbinate resection group (4.47±2.617 vs 3.29±2.301; P=.040*). Middle turbinate resection showed more favourable results than bolgerization concerning the sinus patency outcome after frontal sinusotomy. It also showed a lower incidence of middle meatus synechia postoperatively.

Comparison between the endoscopic scores of bolgerization versus partial resection of the middle turbinate for management of the postoperative lateralization in the early follow-up period after endoscopic frontal sinusotomy: A randomized controlled study

BackgroundFrontal sinusotomy is a challenging procedure that needs meticulous handling due to its unique anatomical position. Postoperative middle turbinate lateralization is critical comorbidity for the success rate, and many techniques are adopted to prevent it. The study aimed to compare the effect of middle turbinate bolgerization and partial resection on the postoperative endoscopic scores and assess their impact on the middle meatus and the frontal recess outcome. Patient and methodsThis prospective study was conducted on forty-one patients undergoing bilateral frontal sinusotomy for chronic frontal sinusitis. Nasal cavities were randomized so that partial middle turbinate resection technique was done alternately with bolgerization approach in every patient. Each participant acted as their control. Both sides were compared using Lund Kennedy Endoscopic Score (LKES) and Perioperative Sinus Endoscopy Score (POSE) at the baseline, 1st, 3rd, and 12th-month intervals postoperatively. Also, middle turbinate status was assessed at the end of the 12th-month interval using POSE score. ResultsThe total frontal sinus patency rate was 82.9% (63/76 operated sinus). Baseline scores, LKES (3.79 ± 0.777 vs 4.05 ± 0.769, p = 0.142, for the side of resection and the side for bolgerization respectively) and POSE (1.79 ± 0.413 vs 1.82 ± 0.393, p = 0.777, for the side of resection and the side for bolgerization respectively). Regarding LKES, the differences between both operated sides were fluctuating with p values: 0.001*, 0.171, and 0.044* for the 1st, 3rd, and 12th months follow-up intervals, respectively. Regarding the POSE score of the frontal sinus, the difference between both groups was steadily increasing with p values: 0.318, 0.119, and 0.017* for the 1st, 3rd, and 12th months follow-up intervals. The middle turbinate's POSE score at the 12th month was significantly higher in the side allocated for bolgerization (p-value = 0.008*). ConclusionPartial middle turbinate resection showed favorable endoscopic outcomes than bolgerization at the 12th month follow up period in patients undergoing primary ESS for chronic frontal sinusitis.

Clinical and Radiologic Characterization of Frontal Sinusitis in the Pediatric Population.

Frontal sinusitis in the pediatric population is a disease that has not been thoroughly studied or characterized. The goals of this study are to characterize the clinical presentation, radiologic variables, treatment modalities, complications, and prognosis associated with acute and chronic frontal sinus disease in the pediatric population. IRB-approved retrospective cohort study of pediatric patients who were diagnosed with acute (AFS) or chronic frontal sinusitis (CFS) and underwent frontal sinus surgery at a tertiary level Children's Hospital from 2006 to 2016. Patients with AFS were compared to patients with CFS. Statistical analysis completed using chi-square test or Fisher's exact test, statistical significance set at P < .05. A total of 19 patients with AFS and 15 patients with CFS were analyzed. There was a male predominance in AFS and female predominance in CFS (P < .05).AFS patients were less likely to have allergies, prior sinus disease, or significant comorbidities (P < .05).Additionally, AFS patients presented with constitutional, neurologic, and ocular symptoms. The CFS group had predominantly sinonasal symptoms. CT-scan analysis showed that AFS patients had higher prevalence of complex frontal anatomy (Type-II cells, concha bullosa) compared with CFS patients (P < .05). Culture results were positive in 78% of the AFS group, with S. Anginosus (53%), Anaerobes (20%), and normal flora (17%). In the CFS group cultures were positive in 60% of the patients, 56% grew normal flora, 13% H. Influenzae, 6.5% Pseudomonas, and 24.5% other species. CFS patients were more likely to have persistent sinus disease and require repeat sinus procedures (P < .05). There are 2 distinct presentations of frontal sinus disease in the pediatric population. Patients with AFS vary significantly from those with CFS. Males, ages 13 to 18 years old, who cultured positive for S. Anginosus (former S.Milleri) dominated the AFS subgroup. Whereas as female patients with a history of allergic rhinitis and muco-cilliary disease were more prominent in the CRS subgroup. Correct identification and understanding of these 2 different entities are crucial for the appropriate short and long-term patient management.

Isolated Frontal Sinusitis and Anosmia: A Novel Presentation

Isolated frontal sinus disease is a rare and highly morbid condition. Although chronic frontal sinusitis has been described in literature, clinically it is quite uncommon in the absence of paranasal sinusitis and rhinitis. Here we examine a case of isolated chronic frontal sinusitis presenting with anosmia—a curious clinical manifestation.

Dual Purpose of De-Epithelialized Latissimus Dorsi Musculocutaneous Flap for Treatment of Chronic Frontal Sinusitis and Frontal Bone Defect.

Treating frontal sinusitis refractory to endoscopic sinus surgery and complicating frontal bone defect remains a challenge. One surgical option determined is free flap transfer, which has the versatility to accommodate adequate sinus obliteration and reconstruct skin and bone defects. After successful free flap transfer, forehead recessus deformity can emerge as an esthetic problem for patients waiting for cranioplasty. Hence, the authors examine three cases in which they performed free latissimus dorsi musculocutaneous (LDM) flaps for chronic frontal sinusitis with frontal bone defect. All LDM flaps survived without complications, and all patients achieved passable forehead contours without cranioplasty and with no occurrence of infection. In our procedure, the muscle portion of the LDM flap was used to obliterate the frontal sinus, which is similar to conventional free LDM flap. Conversely, our procedure also uses the de-epithelialized skin paddle of the LDM flap filled with the frontal bone defect, which is distinct from conventional free LDM flap. Thus, preventing postoperative forehead recessus deformity has been the identified as primary advantage of our procedure. The use of the free de-epithelialized LDM flap transfer fulfills two goals: controlling chronic frontal sinusitis and restoring a passable forehead contour.

Endoscopic management of frontal sinus diseases after frontal craniotomy: a case series and review of the literature.

To evaluate frontal sinus complications developed after previous external craniotomies requiring frontal sinus reconstruction and their treatment with an endoscopic approach. We retrospectively evaluated 22 patients who referred to Sant'Orsola-Malpighi University Hospital and Bellaria Hospital (Bologna, Italy) between 2005 and 2017. All patients presented with frontal sinus disease after frontal craniotomy with sinus reconstruction performed to treat various pathological conditions. We reported our experience in the endoscopic management of such complications and we reviewed the current literature concerning the endoscopic treatment of these conditions. In total, 14 frontal mucoceles, 4 cases of chronic frontal sinusitis, 2 mucopyoceles and 2 fungus ball of the frontal sinus were identified. Endoscopic surgical treatment included 7 DRAF IIa, 1 DRAF IIb, 11 DRAF III and 3 DRAF IIc (modified DRAF III) approaches. The success rate of the surgical procedure was 86% (19/22 patients). Recurrence of the initial pathology occurred in three patients (14%) requiring a conversion of previous frontal sinusotomy into a DRAF III sinusotomy. Frontal sinusopathy can be a long-term complication following craniotomies and may lead to potentially severe pathological conditions, such as mucoceles and frontal sinus inflammation. Its management is still debated and requires recovery of the patency of nasal-frontal route. Our study confirms that the endoscopic endonasal approach may offer a valid solution with low morbidity avoiding re-opening of the craniotomic access. For selected cases, endoscopic approach could also be performed simultaneously to craniotomy as a combined surgery to reduce the risk of short- and long-term complications. Long-term follow-up is mandatory in patients with a history of opened and reconstructed frontal sinus and should include imaging and endoscopic outpatient evaluation.

Indications and Outcomes of the Osteoplastic Flap Procedure With or Without Obliteration.

To describe the osteoplastic approach and to perform a systematic review of the indications and outcomes of the osteoplastic flap procedure for frontal sinus surgeries with or without obliteration. PubMed, Medline, Google Scholar, and Cochrane databases. All published studies in the English language on the osteoplastic flap with or without obliteration were identified from 1905 to 2018. All studies with <20 patients were excluded. The number of patients, technique, indications, follow-up period, symptom relief, revision rates, and complications were recorded and analyzed. A systematic review yielded 25 series containing 1374 patients for analysis. Indications for surgery included chronic frontal sinusitis, mucoceles, fractures or traumas, osteomas, neoplasms, and cerebrospinal fluid leak. The mean follow-up period ranged from 12.8 to 144 months. The percentage of patients needing revisions for frontal sinus disease was 6.2%. There was a high rate of symptomatic improvement (85.0%) and a low rate of major complications (0.7%). However, minor complications occurred in 19.4% of patients. The osteoplastic flap with or without obliteration has many indications. In an era where endoscopic technique provides excellent access to the frontal sinuses, external approaches remain a useful adjunct, and/or salvage technique. In experienced hands, the osteoplastic flap can yield excellent long-term clinical results, with low rates of complications. Regardless of the surgical approach, long-term follow-up is necessary due to the recurrent nature of frontal sinus disease.

Fat obliteration of the front sinus in recurrent frontal sinusitis: a clinical case

Aim. To describe a case of fat obliteration using platelet-rich plasma in a patient with recurrent chronic frontal sinusitis.Materials and methods. A clinical case of a 60-year-old patient who had repeatedly performed extranasal frontotomy for recurrent chronic frontal sinusitis with a short-term effect is described. Due to the ineffectiveness of conservative and traditional surgical treatment, taking into account the characteristics of the clinical picture and the presence of a cosmetic defect in the area of projection of the right frontal sinus, as well as CT results (postoperative bone defect of the right half of the frontal bone), a right-side extranasal frontotomy was performed. The operation involved sinus obliteration with adipose tissue obtained from areas of the thigh anterior surface by lipoaspiration under low pressures with the addition of platelet-rich plasma (PRP) prepared by a single centrifugation of whole venous blood. An assessment of the patient’s condition and fat transplant was carried out on the basis of objective examination after 4 and 6 months and 1.5 year after the surgery and the results of control computed tomography (CT).Results. No complaints regarding nasal breathing from the frontal sinus were registered during control examinations. A good cosmetic result and the absence of pain during palpation in the right frontal sinus were observed. According to CT results, the density of the contents of the frontal sinus corresponded to that of adipose tissue; the volume of material did not changed.Conclusion. Frontal sinus obliteration with adipose tissue and PRP addition is a promising method for treating patients with recurrent chronic frontal sinusitis and repeatedly performed extranasal frontotomy. This method has several advantages over other methods.

Early experience with feasibility of balloon sinus dilation in complicated pediatric acute frontal rhinosinusitis.

Background/ObjectiveComplicated acute rhinosinusitis in the pediatric population is an uncommon problem that may affect the orbit or brain and is life‐threatening. This condition requires surgical intervention with endoscopic sinus surgery for source control, and prior studies have demonstrated the safety of balloon sinuplasty in chronic frontal sinusitis.Methods/ResultsWe present our approach with a balloon sinus dilation hybrid procedure to resolve four distinct types of complicated acute frontal sinusitis in pediatric patients, including intracranial manifestations, intraorbital complications, and recurrent disease. All four patients were able to be managed operatively with frontal balloon sinuplasty.ConclusionsPrior efficacy has been demonstrated for chronic frontal sinusitis in the pediatric population. We demonstrate that frontal balloon sinuplasty is also feasible in the proper clinical setting for acute frontal sinusitis, even in the presence of regional complications or recurrent disease.Level of Evidence4

Plain radiography versus computed tomography scan in evaluation of adults with chronic rhinosinusitis in Zaria, Nigeria

Background: Chronic rhinosinusitis (CRS) can be a debilitating illness with major socioeconomic costs and decreased workplace productivity. Till date, paranasal sinus (PNS) radiography continues to be the primary imaging modality for diagnosing CRS in most developing countries. Computed tomography (CT) scan – the gold standard imaging modality is either unavailable or unaffordable in these regions. Aim: The aim of this study is to compare plain radiographic and CT scan findings of the PNSs in adults with CRS. Subjects and Methods: After initial clinical evaluation and rhinoscopy, consenting patients were assessed using both plain radiography (PR) and direct coronal CT scan of the PNSs. Results: One hundred and eighteen (68 males and 50 females) adults with a mean age of 39.4 years were involved in this study. The percentage agreement between PR and CT for sinus abnormalities was <80%. Using CT scan as the gold standard, PR had the highest diagnostic value in the maxillary sinus with sensitivity and specificity of 76.4% and 89.7%, respectively. Sensitivities and specificities for the ethmoid (50.0% and 76.2%), frontal (35.3% and 89.3%), and sphenoid sinuses (17.1% and 96.1%), respectively, were also recorded. Conclusion: In the diagnosis of chronic maxillary rhinosinusitis, correlation between PR and CT scan was good with high agreement. However, for chronic ethmoidal, frontal, and sphenoidal sinusitis, PR demonstrated poor agreement and weak correlations with CT scan. It is recommended that noncontrast coronal CT scan should replace paranasal PR as the initial imaging modality for evaluating adults with CRS where facilities are available.

Comparison between the draf IIc and standard draf IIb procedure for frontal sinus drainage: single center experience and comparison of outcomes

Aims: Inadequate surgical frontal sinus drainage in chronic sinusitis cases refractory to conservative treatment results in a poor clinical response and is associated with recurrent frontal recess stenosis. Endonasal frontal sinus drainage procedures are classified according to Draf into three groups: DrafIIb enables unilateral orbit to septum drainage and the IIc is the extension of the IIb across the midline. The purpose of our report is to review chronic sinusitis cases treated at our Department using the standard (IIb) or modified (IIc) procedure and compare results. Methods: Patient- and surgery-related data were retrieved on patients operated between 2013 and 2016 for chronic frontal sinusitis using the standard/modified DrafIIb procedure.The modified IIb (i.e. IIc) procedure was performed so that both frontal sinus ostia were visualized by performing an intersinusseptectomy: the aim was to provide drainage to both frontal sinuses simultaneously. Results: In the observed period, 26 patients were treated: 12 using the modified DrafIIb (IIc) and 14 using the standard DrafIIb procedure. There were no significant differences between groups regarding age, sex, number of previous procedures or follow-up period. All patients had an uneventful postoperative recovery and there were no cases of re-stenosis observed in the DrafIIc group; there were seven cases of restenosis in the DrafIIb group.

A prospective study of the prevalence of Kuhn’s frontal cells and their relation to frontal sinus disease

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; The involvement of frontal cells in the frontal sinus disease pathology remains an understudied area. There are very few reports on the prevalence of frontal recess cells in India. In this context the present study was designed to determine the frequency of occurrence of Kuhn frontal cells and to determine whether the size of the frontal isthmus or the presence of frontal cells is related to the presence of frontal sinus disease.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This study included 80 patients who presented with signs and symptoms of chronic rhino-sinusitis after satisfying the inclusion criteria to the Department of ENT in a tertiary care centre (Mahatma Gandhi Medical College and Research Institute) in Pondicherry from January 2017 to April 2018. The patients were subjected to detailed clinical history, basic preoperative blood investigations, diagnostic nasal endoscopy and High Resolution Computed Tomography of nose and para-nasal sinuses after which the diagnosis was established.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Out of the 80 study participants subjected to our study the number of individuals who had frontal sinusitis was 50%. The association between frontal sinusitis and Kuhn cells was insignificant. The mean value of anteroposterior diameter of the naso-frontal isthmus in case of patients with and without frontal sinusitis was 0.705-0.735. In case of transverse diameter it was 0.725-0.720 and in case of the area of the frontal isthmus it was 30.86-31.12 which had a p value of 0.49&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Therefore in our study we concluded that there is no significant relation for any particular frontal recess cell or the size of the nasofrontal isthmus for being the sole cause for chronic frontal sinusitis.&lt;/p&gt;