STUDY OF THE CONFIGURATION OF THE FRONTAL RECESS AND ITS RELATIONSHIP WITH FRONTAL SINUSITIS BASED ON COMPUTED TOMOGRAPHY
Clinical medicine

STUDY OF THE CONFIGURATION OF THE FRONTAL RECESS AND ITS RELATIONSHIP WITH FRONTAL SINUSITIS BASED ON COMPUTED TOMOGRAPHY

Published 2025-08-28

Authors:

A.V. Loburets

Abstract:
The anatomical complexity of the frontal-ethmoid region is a key factor influencing frontal sinus drainage and increasing the risk of frontal sinusitis. The identification of objective morphometric predictors can improve diagnosis, prognosis and surgical planning in frontal sinus pathology. The aim of the study was to establish the relationship between the complexity of the anatomy of the frontal recess and the presence of frontal sinusitis by analysing the index of surgical complexity and the anterior-posterior distance based on computed tomography in 120 patients (233 anatomical sides). Signs of frontal sinusitis were detected in 26.3% of cases. In the group with frontal sinusitis, the mean of the index of surgical complexity was 2.71±0.89 score, the anterior-posterior distance – 7.98±2.29 mm; in the group without frontal sinusitis – 2.59±0.71 score and 8.38±2.02 mm, respectively. Despite the absence of statistically significant differences (p>0.05), a decrease in anterior-posterior distance and an increase in the index of surgical complexity were accompanied by an increase in the frequency of inflammation. The results obtained indicate the potential prognostic value of these parameters and justify their inclusion in a comprehensive preoperative analysis.
Keywords:
frontal sinusitis International Classification of the Radiological Complexity anterior-posterior distance frontal sinus computed tomography
References:
  1. Al Habsi T, Al-Ajmi E, Washahi MA, Lawati MA, Maawali SA, Mahajan A, et al. Does Frontal Recess Cell Variation Associate with the Development of Frontal Sinusitis? A Narrative Review. Diagnostics (Basel). 2024 Jan 3;14(1):103. doi: 10.3390/diagnostics14010103.
  2. Bousquet J, Toumi M, Sousa-Pinto B, Anto JM, Bedbrook A, Kaidashev I, et al. The Allergic Rhinitis and Its Impact on Asthma (ARIA) Approach of Value-Added Medicines: As-Needed Treatment in Allergic Rhinitis. J Allergy Clin Immunol Pract. 2022 Nov;10(11):2878-2888. doi: 10.1016/j.jaip.2022.07.020.
  3. Choby G, Thamboo A, Won TB, Kim J, Shih LC, Hwang PH. Computed tomography analysis of frontal cell prevalence according to the International Frontal Sinus Anatomy Classification. Int Forum Allergy Rhinol. 2018 Jul;8(7):825-830. doi: 10.1002/alr.22105.
  4. Fawzi NEA, Lazim NM, Aziz ME, Mohammad ZW, Abdullah B. The prevalence of frontal cell variants according to the International Frontal Sinus Anatomy Classification and their associations with frontal sinusitis. Eur Arch Otorhinolaryngol. 2022 Feb;279(2):765-771. doi: 10.1007/s00405-021-06843-0.
  5. Feng Y, Yan S, Wang J, Liu Y, Li X. [The role of supraorbital ethmoid cell and the significance of a proposed classification of the anterior ethmoid artery in endoscopic sinus surgery]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Jun;35(6):495-500. doi: 10.13201/j.issn.2096-7993.2021.06.003. [in Chinese].
  6. Jang DW, Lachanas VA, White LC, Kountakis SE. Supraorbital ethmoid cell: a consistent landmark for endoscopic identification of the anterior ethmoidal artery. Otolaryngol Head Neck Surg. 2014 Dec;151(6):1073-1077. doi: 10.1177/0194599814551124.
  7. Jaremek-Ochniak W, Sierdziński J, Popko-Zagor M. Three-dimensional computed tomography analysis of frontal recess cells according to the International Frontal Sinus Anatomy Classification (IFAC) - difficulties in identification of frontal recess cells in patients with diffuse primary chronic rhinosinusitis? Otolaryngol Pol. 2022 Jan 14;76(2):7-14. doi: 10.5604/01.3001.0015.6959.
  8. Johari HH, Mohamad I, Sachlin IS, Aziz ME, Mey TY, Ramli RR. A computed tomographic analysis of frontal recess cells in association with the development of frontal sinusitis. Auris Nasus Larynx. 2018 Dec;45(6):1183-1190. doi: 10.1016/j.anl.2018.04.010.
  9. Loburets A, Loburets V, Bezega M, Gasiuk I. The study of frontal recess configurations based on computed tomography data and their association with frontal sinusitis. Pol Otorhino Rev. 2024;13(4):7-12. doi: 10.5604/01.3001.0054.8393.
  10. Nair PP, Varghese A, Kumar N, Varghese SS. Computed Tomographic Study of Frontal Sinus Cells and Opacification as Per the International Frontal Sinus Anatomy Classification. Indian J Otolaryngol Head Neck Surg. 2024;76(4):3451-3457. doi: 10.1007/s12070-024-04724-6.
  11. Nofal AAB, El-Anwar MW. Frontal Recess Cells in International Frontal Sinus Anatomy Classification (IFAC); Prevalence, Infection Incidence, and Relation to Frontal Sinus Infection in Chronic Sinusitis Patients. Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(Suppl 3):4748-4755. doi: 10.1007/s12070-021-03069-8.
  12. Voloshan OO, Grigorov SM, Demyanyk DS, Ruzin GP, Lokes KP. Prospects of an automated computer software implementation for prediction of course and treatment in patients with different forms of odontogenic maxillary sinusitis. World of Medicine and Biology. 2019;4(70):39–45. doi:10.26724/2079-8334-2019-4-70-39-45.
  13. Wormald PJ, Bassiouni A, Callejas CA, Kennedy DW, Citardi MJ, Smith TL, et al. The International Classification of the Radiological Complexity (ICC) of Frontal Recess and Frontal Sinus. Int Forum Allergy Rhinol. 2017 Apr;7(4):332-337. doi: 10.1002/alr.21893.
  14. Wormald PJ, Hoseman W, Callejas C, Weber RK, Kennedy DW, Citardi MJ, et al. The International Frontal Sinus Anatomy Classification (IFAC) and Classification of the Extent of Endoscopic Frontal Sinus Surgery (EFSS). Int Forum Allergy Rhinol. 2016;6(7):677-696.
Publication:
«World of Medicine and Biology» Vol. 21 No. 93 (2025) , с. 100-104
УДК 616.211-002-073.7:611.013.7