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The prevalence of frontal cell variants according to the International Frontal Sinus Anatomy Classification and their associations with frontal sinusitis

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Background

The International Frontal Sinus Anatomy Classification (IFAC) is introduced to simplify the classification of different frontal cell variants based on their topographical structures. The objectives of our study were to determine the prevalence of the frontal cell variants according to IFAC and their association with the development of frontal sinusitis.

Methodology

A retrospective chart review on computed tomography paranasal sinus (CTPNS) was conducted. A total of 200 patients who had clinical and endoscopic findings of chronic rhinosinusitis (CRS) and undergone CTPNS were reviewed. The CTPNS was evaluated for the presence of frontal cell variants according to IFAC and mucosal changes consistent with frontal sinus involvement.

Result

A total of 400 sides of the CTPNS were analyzed. The agger nasi cells (ANCs) were the most common (95.5%) followed by supra bulla cells (SBCs) (60.8%), supra bulla frontal cells (SBFCs) (53.0%), supra agger cells (SACs) (50.0%), supra agger frontal cells (SAFCs) (36.0%), frontal septal cells (FSCs) (8.3%), and supraorbital ethmoidal cells SOECs (5.5%). There was significant association between SOEC (p = 0.001) and FSC (p = 0.044) with the development of frontal sinusitis.

Conclusions

Apart from ANCs, the posterior-based cells (SBCs and SBFCs) have higher prevalence than the anterior-based cells (SACs and SAFCs). Despite being the least, both SOECs and FSCs are significantly associated with frontal sinusitis.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia

    Noor Elyana Ahmad Fawzi, Norhafiza Mat Lazim & Baharudin Abdullah

  2. Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia

    Mohd Ezane Aziz

  3. Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia

    Zahiruddin Wan Mohammad

Authors
  1. Noor Elyana Ahmad Fawzi
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  2. Norhafiza Mat Lazim
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  3. Mohd Ezane Aziz
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  4. Zahiruddin Wan Mohammad
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  5. Baharudin Abdullah
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Correspondence to Baharudin Abdullah.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Human Research Ethical Review Board (JEPeM Code: USM/JEPeM/18120778) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Fawzi, N.E.A., Lazim, N.M., Aziz, M.E. et al. The prevalence of frontal cell variants according to the International Frontal Sinus Anatomy Classification and their associations with frontal sinusitis. Eur Arch Otorhinolaryngol 279, 765–771 (2022). https://doi.org/10.1007/s00405-021-06843-0

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  • DOI: https://doi.org/10.1007/s00405-021-06843-0

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