scholarly journals Frontal Recess Cells in International Frontal Sinus Anatomy Classification (IFAC); Prevalence, Infection Incidence, and Relation to Frontal Sinus Infection in Chronic Sinusitis Patients

Author(s):  
Ahmed Abdelfattah Bayomy Nofal ◽  
Mohammad Waheed El-Anwar

AbstractFrontal recess cells have many types with different sizes, arrangement, and extend. It plays an important role in successful functional endoscopic sinus surgery (FESS) as most causes of failure are related to it. Outline the prevalence of the frontal recess cells, pathological incidence of each cell regarding to frontal sinus pathology. Prospective study on 100 consecutive patients (200 sides) complaining from nasal and sinus symptoms which did not respond to medical management and indicated for FESS. Anterior group was infected in 30.8%; agger nasi cell (ANC) present in 97% (25.8% infected, 74.2% not infected), supra agger cell (SAC) present in 48% (39.6% infected, 60.4% not infected), supra agger frontal cell (SAFC) present in 11% (36.4% infected, 63.6% not infected). Posterior group was infected in 24.8%; supra bulla cell (SBC) present in 72% (30.6% infected, 69.4% not infected), supra bulla frontal cell (SBFC) present in 23% (17.4% infected, 82.6% not infected), supra orbital ethmoid cell (SOEC) present in 42% of cases (19% infected, 81% not infected). Medial group [frontal septal cell (FSC)] was present in 21% (33.3% infected, 66.7% not infected). FSC, SAC, SAFC, and SBC showed high infection rate in association with infected frontal sinus, while, the SOEC, ANC, and SBFC did not have such high infection rate. Frontal recess cells show no difference in their prevalence either if the frontal sinus infected or not, however their infection rate show significant difference.

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Ahmed Z. Eweiss ◽  
Hisham S. Khalil

Background. The frontal recess area represents a challenge to ENT surgeons due to its narrow confines and variable anatomy. Several types of cells have been described in this area. The agger nasi cells are the most constant ones. The frontal cells, originally classified by Kuhn into 4 types, have been reported in the literature to exist in 20%–41% of frontal recesses. Aim of the Study. To identify the prevalence of frontal recess cells and their relation to frontal sinus disease. Methods. Coronal and axial CT scans of paranasal sinuses of 70 patients admitted for functional endoscopic sinus surgery (FESS) were reviewed to identify the agger nasi, frontal cells, and frontal sinus disease. Data was collated for right and left sides separately. Results. Of the 140 sides reviewed, 126 (90%) had agger nasi and 110 (78.571%) had frontal cells. 37 frontal sinuses were free of mucosal disease, 48 were partly opacified, and 50 were totally opacified. There was no significant difference found in frontal sinus mucosal disease in presence or absence of frontal cells or agger nasi. Conclusions. The current study shows that frontal cells might be underreported in the literature, as the prevalence identified is noticeably higher than previous studies.


ORL ◽  
2008 ◽  
Vol 70 (2) ◽  
pp. 84-90 ◽  
Author(s):  
Zhou Bing ◽  
Han Demin ◽  
Liu Huachao ◽  
Huang Qian ◽  
Zhang Luo ◽  
...  

2019 ◽  
Vol 12 ◽  
pp. 117955061988494
Author(s):  
Seiichiro Makihara ◽  
Shin Kariya ◽  
Mitsuhiro Okano ◽  
Tomoyuki Naito ◽  
Kensuke Uraguchi ◽  
...  

Objective: The agger nasi cell (ANC) is an easily identifiable landmark when approaching the frontal sinus. The success of endoscopic frontal sinus surgery may be influenced by the width of the frontal recess (FR). The aim of this study is to examine the relationship between the FR width and the ANC size in Japanese patients. In addition, the effect of various frontal recess cells (FRCs) on the development of frontal sinusitis has been examined. Materials and methods: Multiplanar computed tomography (CT) scans of the nasal cavities and paranasal sinuses in 95 patients (190 sides) before endoscopic sinus surgery were reviewed. The presence of FRCs, the thickness of the frontal beak (FB), the ANC size, and the anterior-to-posterior (A-P) length of the frontal isthmus (FI) and FR were evaluated in patients with and without frontal sinusitis. Results: The prevalence of the ANC, frontal cell types 1, 2, 3, and 4, frontal bullar cell (FBC), suprabullar cell, supraorbital ethmoid cell, and interfrontal sinus septal cell was 85.3%, 11.6%, 0%, 7.9%, 0%, 25.3%, 45.8%, 16.8%, and 15.3%, respectively. The ANC volume showed a significant positive correlation with the A-P length of the FI and FR. The incidence of frontal sinusitis in the patients with FBCs was significantly higher than that without FBCs. Conclusion: A large ANC offers a greater potential to facilitating the approach to the frontal sinus because of the extensiveness of the FR in Japanese patients. The presence of FBCs may be related to a higher incidence of frontal sinusitis.


2020 ◽  
Vol 2 (1) ◽  
pp. 5
Author(s):  
Sung-Won Kim

<p>The proportion of critically ill patients from neurosurgery wards in hospitals is significantly higher than that from other departments. These patients suffer from low immune. At the same time, because of the severe trauma after surgery and the complexity of pathogens in patients, antibiotics are frequently used. However, the of bacterial drug resistance is relatively high because of the particularity of hospitals, which is a major reason for the high infection rate of neurosurgery patients. Therefore, regarding to these risk factors, intervention measures should be actively explored in hospitals, so as to control the infection rate, reduce the possibility of infection in neurosurgery patients, improve the rehabilitation efficiency of patients, and reduce unnecessary suffering of patients caused by infection. This is also an effective means to improve the quality of hospital medical care. </p>


2019 ◽  
Vol 33 (3) ◽  
pp. 323-330 ◽  
Author(s):  
Luan V. Tran ◽  
Ngoc H. Ngo ◽  
Alkis J. Psaltis

Background To date, there are numerous studies documenting the prevalence of frontal recess cells, but only 1 study using the newly developed International Frontal Sinus Anatomical Classification (IFAC) system. The identification of the frontal cells and their influence on the frontal drainage pathway plays an important role in endoscopic frontal sinus surgery. Objective The aim of this study is to document the radiological prevalence of various types of frontal cells, as classified by IFAC and the most common frontal sinus drainage pathways based on its anatomic relationships with these cells. Methods Using a novel preoperative virtual planning software (Scopis Building Blocks), consecutive computerized tomography scans of the sinuses of patients were analyzed for the prevalence of frontal cells, as classified by the by IFAC, and the frontal sinus drainage pathways at the Ear Nose Throat Hospital of Ho Chi Minh City, Vietnam. Results In this study, 208 computed tomography scans of consecutively selected frontal sinuses of 114 patients were included for analysis. The agger nasi cell was present in 95.7% of reviewed scans. The frontal cells prevalence was as follows: supra agger cell (SAC): 16.3%, supra agger frontal cell (SAFC): 13%, supra bulla cell (SBC): 46.2%, supra bulla frontal cell (SBFC): 4.3%, supra orbital ethmoid cell: 17.3%, and frontal septal cell: 10.6%. The most common frontal sinus pathway type in relation to frontal cells was medial to SAC (70.6%), medial to SAFC (81.5%), anterior to SBC (88.5%), and anterior to SBFC (100%). In cases that had 2 frontal cells group, the drainage pathway was medial to SAC/SAFC and anterior to SBC/SBFC in most cases. Conclusion This study documents the prevalence of frontal cells (classified by IFAC) using a novel preoperative virtual planning software in the Vietnamese population. It demonstrates predominantly medial anteromedial frontal drainage pathways as related to these frontal cells.


2009 ◽  
Vol 23 (3) ◽  
pp. 342-347 ◽  
Author(s):  
Samuel Hahn ◽  
James N. Palmer ◽  
Michael T. Purkey ◽  
David W. Kennedy ◽  
Alexander G. Chiu

Background In the modern age of endoscopic sinus surgery (ESS), there is an undefined role for external approaches in the treatment of inflammatory disease. This study examines the frontal sinus surgery practices of three experienced rhinologists with a focus on those who underwent an external approach. Our goal was to characterize these patients and propose indications for the use of an external approach alone or in combination with functional ESS (FESS) for frontal sinus inflammatory disease. Methods A retrospective review was performed of frontal sinus procedures performed for inflammatory disease at one institution from 2004 to 2007. Results Seven hundred seventeen procedures were performed, 38 (5.3%) of which were external alone (14 procedures) or in combination with FESS (24 procedures). Osteoplastic flap with obliteration (12/14) made up the majority of external alone procedures and the most common indication was neo-osteogenesis of the frontal recess. Trephination was the most common external adjunct to FESS (12/24), and often was performed for type 3 frontal recess cells or in the initial management of acute frontal bone osteomyelitis (FOM). Twenty-eight of 38 (74%) patients had a history of previous surgery. Of the 10 patients with no history of previous surgery, 6 (60%) had an external adjunct for frontal recess neo-osteogenesis. There were no major complications but 9/38 (23.7%) patients required revision surgery for persistent/recurrent symptoms. Conclusion External approaches alone and in combination with FESS are predominantly secondary to neo-osteogenesis of the frontal recess. Factors associated with neo-osteogenesis include previous trauma, endoscopic surgery, and FOM. External frontal sinus surgery provides adequate management of inflammatory disease but has a high revision rate.


2017 ◽  
Vol 156 (5) ◽  
pp. 946-951 ◽  
Author(s):  
Neil S. Patel ◽  
Amy C. Dearking ◽  
Erin K. O’Brien ◽  
John F. Pallanch

Objective To define relationships between the frontal sinus opening, ostia of other frontal recess cells, and endoscopic landmarks and to develop a clinically useful framework to guide frontal sinus surgery. Study Design Retrospective review. Setting Tertiary care academic referral center. Methods Adult patients with computed tomography (CT) without sinonasal pathology were included. Virtual endoscopy (using OsiriX) and corresponding CT reconstructions were used to identify all visible ostia in the frontal recess and characterize their positions in spaces between the uncinate/agger nasi (U), bulla ethmoidalis (EB), and middle turbinate (MT). Results Two hundred sides in 100 patients (median age 51 years, 62% female) were analyzed. The “center” of each map was defined as the intersection of spaces between U, EB, and MT. The frontal sinus opening was in the “center” in 53% of frontal recesses, lateral to this position in 29%, and anterior in 11%. When the frontal sinus opening was at the “center,” anterior ostia drained frontal Kuhn T cells in 51% and intersinus septal cells in 23%. The skull base attachment of the apical strut of the uncinate process demarcated medial and lateral within the space between U and EB, with the opening to the frontal sinus medial in 68% and lateral in 31%. Left-right asymmetry in frontal sinus openings was noted in 46% of patients. Conclusion Combining preoperative imaging and knowledge of these anatomic relationships may facilitate more efficient frontal outflow tract identification and instrumentation. This represents the first and largest description of ostial configurations relative to endoscopic structural landmarks. Level of Evidence: 4


Parasite ◽  
2013 ◽  
Vol 20 ◽  
pp. 3 ◽  
Author(s):  
Vesna Lalošević ◽  
Dušan Lalošević ◽  
Ivan Čapo ◽  
Verica Simin ◽  
Annamaria Galfi ◽  
...  

2009 ◽  
Vol 2 (3) ◽  
pp. 15-20 ◽  
Author(s):  
AK Agarwal ◽  
Shruti Dhingra ◽  
JC Passey ◽  
JM Kaul

Abstract Surgery of the frontal sinus has gone a full circle from intranasal procedures to destructive and disfiguring external operations and now back to intranasal procedures but with endoscopes. Endoscopic surgery of the frontal sinus has always been a challenging experience because of the narrowness of the area, poor visibility, variable anatomy and encroachment by accessory cells such as agger nasi, frontal, intersinus septal cells on the drainage pathway. With the developments in optical aids such as endoscopes, which provide an angled view, better and brighter illumination, sophistication in the designs of instrumentation and development of imaging techniques, a renewed interest has been created in this area, but the knowledge of anatomy of this area is poor and does not meet the demands of the present day endoscopic surgeon. Moreover, no studies are available on Indian subjects. Our main interest in the present study was to study the various air cells which encroach the area of frontal recess and would need surgical removal to provide a good drainage and ventilation.


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