Association of Frontal Recess Anatomy and Uncinate Process Variations With Frontal Sinusitis: A CT-Based...

Area of Science:

• Otolaryngology
• Radiology
• Anatomy

Background:

• Frontal sinusitis is associated with anatomical variations affecting sinus drainage.
• Frontal recess cells (International Frontal Sinus Anatomy Classification - IFAC) and uncinate process variations are key factors.
• Understanding these anatomical relationships is crucial for managing frontal sinusitis.

Purpose of the Study:

• To investigate the association between frontal recess cells (IFAC) and uncinate process variations with frontal sinusitis.
• To determine the correlation between specific frontal recess cells and the severity of frontal sinusitis.

Main Methods:

• Retrospective analysis of 144 paranasal sinus computed tomography (PNSCT) scans (70 frontal sinusitis patients, 74 controls).
• Evaluation of frontal recess cells using IFAC and uncinate process variations via Landsberg and Friedman classification.
• Assessment of frontal sinusitis severity using the Lund-Mackay scoring system.

Main Results:

• Supra-agger cells (SAC) and supra-bullar cells (SBC) were significantly more prevalent in patients with frontal sinusitis (p < 0.001).
• A positive correlation was observed between SAC, SBC, and supra-bullar frontal cells and higher frontal sinus Lund-Mackay scores (p < 0.001, p < 0.001, p = 0.002).
• No significant association was found between uncinate process variations and frontal sinusitis (p = 0.167).

Conclusions:

• Frontal recess cells, particularly SAC and SBC, are associated with increased susceptibility to frontal sinusitis, likely due to impaired drainage.
• Identifying these anatomical variations is important for improving surgical planning and management of frontal sinusitis.