Multiplanar Computed Tomographic Analysis of Frontal Cells According to International Frontal Sinus Anatomy Classification and Their Relation to Frontal Sinusitis

Abstract

Background:

This study explored the prevalence of frontal cells and the relationship between different types of frontal cells classified using the International Frontal Sinus Anatomy Classification (IFAC) and frontal sinusitis.

Methods:

A retrospective cross-sectional study was conducted with 1006 CT scans of paranasal sinuses. Identification of frontal sinus cells was based on IFAC. The scans were classified into no frontal sinusitis, frontal sinusitis, isolated frontal sinusitis, no sinusitis.

Results:

Agger nasi cells were the most common (91.9%). The prevalence of supra agger cell (SAC) was 28.7%, while the supra agger frontal cell (SAFC) was only 15.8%, the supra bulla cell (SBC) was 59.7%, the supra bulla frontal cell (SBFC) was 25.8%. Supra orbital ethmoid cell (SOEC) and frontal septal cell (FSC) were identified in 6.9% and 14.3% of the cases, respectively. Patients with SAFCs and SBFCs were significantly more likely to develop frontal sinusitis (Odds Ratio (OR)=1.78, 95% confidence interval (CI) 1.24–2.56 and OR=2.70, 95% CI 1.98–3.66). Isolated frontal sinusitis was found in 10 scans and was associated with the presence of SAC (OR=3.76, 95% CI 1.02–13.90).

Conclusion:

In Vietnamese adult patients, frontal cells based on IFAC were prevalent and were associated with frontal sinusitis development, including isolated frontal sinusitis.

Keywords:

• International Frontal Sinus Anatomy Classification
• frontal sinusitis
• frontal cells
• multiplanar computed tomographic analysis

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Ethical Approval

All procedures followed were approved and were in accordance with the ethical standards of the responsible committee on human experimentation (Ethics Committee at the University of Medicine and Pharmacy at Ho Chi Minh City; approval number: 416/DHYD-HDDD) and with the Helsinki Declaration of 1975, as revised in 2000. This study was based on the retrospective review of medical records when all patients had been discharged and thus the need for informed consent from each individual patient was waived by the Committee. All patient data were kept confidential in according to the Vietnam national standard.

Acknowledgment

We highly appreciate about the cooperation of Radiology Department at University Medical Center in Ho Chi Minh City and we would like to extend our gratitude to patients for providing us to conduct this study.

Funding

The authors received no specific funding for this study.

Disclosure

The authors declare no conflicts of interest for this work.