A novel anatomical classification of the frontal sinus: can it be useful in clinical approach to frontal sinusitis?

Abstract

Background We aimed to test the clinical relevance of a newly introduced anatomical classification system of the frontal sinus and to investigate the relation between the frontal sinus type according to this system and the development of frontal sinusitis. We retrospectively evaluated the computed tomography images of 808 frontal sinuses of 404 patients and classified the sinuses as small, medium-sized, and large, based on their size and relation to the orbital roof. We related this classification to the presence or absence of the findings of frontal sinusitis including mucosal thickening, retention cyst/polyp, and/or fluid collection. Results We found that the most common frontal sinus type is medium-sized (65.84%), followed by the small (22.89%) and large (11.26%) types, respectively. There was no significant difference between the right and left sides in terms of frontal sinus type (P<0.05). We recorded sinusitis in 28 (15.1%) small, 180 (33.8%) medium-sized, and 40 (43.9%) large sinuses. And we showed that the prevalence of sinusitis in medium-sized and large sinuses is significantly higher than that in small sinuses for both sides (P values were 0.001 and 0.015, respectively for the right, and 0.005 and 0.001, respectively for the left side). Conclusion The result obtained in this study may be considered the first step in demonstrating the clinical benefit of this classification. However, there is no doubt that further comprehensive studies with large series are needed to fully determine the clinical relevance of this newly introduced classification system.

Anatomical variations of the frontal sinus: A computed tomography-based study

“… 10 Similar to previous studies, in the present study, the medium-sized category of frontal sinus was the most common type of frontal sinus morphology. 10 , 12 , 22 The values of medium-sized frontal sinus frequency observed in the present study are comparable with the frequency of 65.84% reported in a recent study by Ozdemir et al 22 In contrast, in a study by Yüksel Aslier et al , hyperplasia (44.5%) was the most common type, followed by medium-sized (37.2%), hypoplasia (14.2%) and aplasia (4.1%) categories. 11 Similarly, in a study by Buller et al , following Guerram et al ’s morphologic classification, hyperplasia was found to be the most frequent sinus category (66%), followed by medium-sized (30.2%) and hypoplasia (3.8%) categories.…”

“…[16][17][18][19][20] recent study reported a significant association between the frontal sinus type and frontal sinusitis frequency. 22 In the same study, the prevalence of sinusitis in mediumsized and large sinuses was significantly higher than in small sinuses. 22 Hence, the baseline data of frontal sinus types reported in the present study is helpful in the diagnostic evaluation of sinusitis in the clinical setting.…”

Anatomical variations of frontal sinus pneumatization: A computed tomography-based study

“…10 Similar to previous studies, in the present study, the mediumsized category of frontal sinus was the most common type of frontal sinus morphology. 10,12,22 The values of mediumsized frontal sinus frequency observed in the present study are comparable with the frequency of 65.84% reported in a recent study by Ozdemir et al 22 In contrast, in a study by Yüksel Aslier et al, hyperplasia (44.5%) was the most common type, followed by medium-sized (37.2%), hypoplasia (14.2%) and aplasia (4.1%) categories. 11 Similarly, in a study by Buller et al, following Guerram et al's morphologic classification, hyperplasia was found to be the most frequent sinus category (66%), followed by medium-sized (30.2%) and hypoplasia (3.8%) categories.…”

“…[16][17][18][19][20] Another recent study reported a significant association between the frontal sinus type and frontal sinusitis frequency. 22 In the same study, the prevalence of sinusitis in mediumsized and large sinuses was significantly higher than in small sinuses. 22 Hence, the baseline data of frontal sinus types reported in the present study is helpful in the diagnostic evaluation of sinusitis in the clinical setting.…”

“…22 In the same study, the prevalence of sinusitis in mediumsized and large sinuses was significantly higher than in small sinuses. 22 Hence, the baseline data of frontal sinus types reported in the present study is helpful in the diagnostic evaluation of sinusitis in the clinical setting. The preoperative recognition of frontal sinus types, particularly frontal sinus aplasia in multiplanar CT scans, is crucial to avoid unexpected complications while performing endoscopic sinus surgery.…”