scholarly journals Is it More Reasonable to Categorize Frontal Cells on the Basis of their Location Rather than on their Type?

2010 ◽  
Vol 89 (9) ◽  
pp. E19-E21
Author(s):  
Altan Yildirim
Keyword(s):  
Frontal Sinus ◽  
Chronic Sinusitis ◽  
Cell Types ◽  
Ct Scans ◽  
Frontal Sinusitis ◽  
Concha Bullosa ◽  
Frontal Recess ◽  
Group A ◽  
Left And Right ◽  
Group B

Frontal cells appear in two locations—in the frontal recess and in the frontal sinus. The aim of this study was to analyze the anatomic and clinical differences between the frontal cells at each location. The author reviewed 487 left and right sides of coronal computed tomography (CT) scans of the sinuses obtained from 300 consecutively presenting patients (600 sides) who were being evaluated for chronic sinusitis. For the purposes of this study, the frontal cells were classified according to location; group A cells were located in the area of the frontal recess (Bent and Kuhn cell types I and II), and group B cells were those that had invaded the frontal sinus itself (Bent and Kuhn cell types III and IV). The presence or absence of frontal sinusitis and concha bullosa was determined, as was the degree of frontal sinus pneumatization. Analysis revealed statistically significant differences between group A and group B in all three parameters; the prevalence of frontal sinusitis and hyperpneumatization of the frontal sinus was higher in group B, and the prevalence of concha bullosa was higher in group A (all p < 0.05). These findings imply that it might be more reasonable both clinically and anatomically to categorize frontal cells based on their location rather than on their Bent and Kuhn type.

scholarly journals The Relationship Between the Width of the Frontal Recess and the Frontal Recess Cells in Japanese Patients

2019 ◽  
Vol 12 ◽  
pp. 117955061988494
Author(s):  
Seiichiro Makihara ◽  
Shin Kariya ◽  
Mitsuhiro Okano ◽  
Tomoyuki Naito ◽  
Kensuke Uraguchi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Frontal Sinus ◽  
Significant Positive Correlation ◽  
Japanese Patients ◽  
Cell Types ◽  
Sinus Surgery ◽  
Ct Scans ◽  
Frontal Sinusitis ◽  
Frontal Recess ◽  
The Relationship

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.

The Effect of Middle Turbinate Resection upon the Frontal Sinus

1995 ◽  
Vol 9 (4) ◽  
pp. 191-196 ◽  
Author(s):  
Paul B. Swanson ◽  
Donald C. Lanza ◽  
Eugenia M. Vining ◽  
David W. Kennedy
Keyword(s):  
Frontal Sinus ◽  
Statistical Difference ◽  
Severe Disease ◽  
Middle Turbinate ◽  
Sinus Surgery ◽  
Ct Scans ◽  
Control Group ◽  
Case Group ◽  
Frontal Sinusitis ◽  
Frontal Recess

Diversity of opinion exists among otolaryngologists regarding the importance of preserving the middle turbinate during sinus surgery. The purpose of this study is to determine whether or not middle turbinate resection has a bearing upon postoperative disease within the frontal sinus. In this retrospective analysis of 110 consecutive patients with chronic or recurrent acute sinusitis, 69 (case group) had previous middle turbinectomy and 41 patients (control group) had intact middle turbinate after prior sinus surgery. In 42 patients, CT scans were scored and defined as having either mild-moderate or severe disease. Frontal sinusitis seen on CT scan was present in 75% (30 of 40) of case sides and 45% (9 of 20) of control sides, and this difference was significant (P < 0.05). The height of middle turbinate resection was measured, and there was no statistical difference in frontal sinusitis between patients with high and low resection. Therefore, this work does not support the concept that middle turbinate resection results in a lower incidence of frontal recess disease.

Computed tomographic analysis of the prevalence of International Frontal Sinus Anatomy Classification cells and their association with frontal sinusitis

2020 ◽  
Vol 134 (10) ◽  
pp. 887-894
Author(s):  
N Seth ◽  
J Kumar ◽  
A Garg ◽  
I Singh ◽  
R Meher
Keyword(s):  
Computed Tomography ◽  
Frontal Sinus ◽  
Clinical Symptoms ◽  
Cell Types ◽  
Frontal Sinusitis ◽  
Prevalence Rates ◽  
Computed Tomographic ◽  
Significant Difference ◽  
Left And Right ◽  
Tomographic Analysis

AbstractObjectivesTo determine the radiological prevalence of frontal cells according to the International Frontal Sinus Anatomy Classification in patients undergoing computed tomography of the paranasal sinuses for clinical symptoms of chronic rhinosinusitis, and to examine the association between cell classification and frontal sinusitis development.MethodsA total of 180 (left and right) sides of 90 patients were analysed. The prevalence of each International Frontal Sinus Anatomy Classification cell was assessed. Logistic regression analysis was used to compare the distribution of various cells in patients with and without frontal sinusitis.ResultsThe agger nasi cell was the most commonly occurring cell, seen in 95.5 per cent of patients. The prevalence rates for supra agger cells, supra agger frontal cells, supra bullar frontal cells, supra bullar cells, supra-orbital ethmoid cells and frontal septal cells were 33.3 per cent, 22.2 per cent, 21.1 per cent, 36.1 per cent, 39.4 per cent and 21.1 per cent, respectively. There was no significant difference in the occurrence of any of the cell types in patients with frontal sinusitis compared to those without (p > 0.05).ConclusionThe presence of any of the International Frontal Sinus Anatomy Classification cells was not significantly associated with frontal sinusitis.

scholarly journals The association of frontal recess anatomy and mucosal disease on the presence of chronic frontal sinusitis: a computed tomographic analysis

2014 ◽  
Vol 52 (3) ◽  
pp. 208-214
Author(s):  
W.-S. Lai ◽  
P.-L. Yang ◽  
C.-H. Lee ◽  
Y.-Y. Lin ◽  
Y.-H. Chu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Strong Association ◽  
Ct Scans ◽  
Mucosal Inflammation ◽  
Frontal Sinusitis ◽  
Logistic Regression Models ◽  
Computed Tomographic ◽  
Frontal Recess ◽  
Inflammatory Conditions ◽  
Increased Risk

Objectives: The frontal sinus has the most complex and variable drainage routes of all paranasal sinus regions. The goal of this study was to identify these anatomical factors and inflammation areas relating to chronic frontal sinusitis by comparing radiological presentations in patients with and without frontal sinusitis. Methods: All adult patients with chronic rhinosinusitis who had received computed tomography (CT) scans of the nasal cavities and paranasal sinuses between October 2010 and September 2011. Logistic regression analysis was used to compare the distribution of various frontal recess cells and surrounding inflammatory conditions in patients with and without frontal sinusitis. Results: Analysis of 240 sides of CT scans was performed with 66 sides excluded. The opacification of the frontal recess and sinus lateralis demonstrated a strong association with an increased presence of frontal sinusitis by multiple logistic regression models. Conclusion: Opacification of the frontal recess and sinus lateralis was found to be associated with a significantly increased risk of frontal sinusitis and developing severe blockage of drainage pathways. It provides evidence that mucosal inflammation disease in these two areas is a very important factor leading to chronic frontal sinusitis.

scholarly journals CLINICAL STUDY ON SHIREESHADI AVAPEEDANA NASYA IN THE MANAGEMENT OF SURYAVARTHA (FRONTAL SINUSITIS)

2021 ◽  
Vol 9 (8) ◽  
pp. 1654-1658
Author(s):  
Amarnath H K
Keyword(s):  
Clinical Study ◽  
Economic Status ◽  
Age Groups ◽  
Frontal Sinusitis ◽  
Nasal Blockage ◽  
X Ray ◽  
Group A ◽  
Foul Smell ◽  
Group B ◽  
Clinical Conditions

Nasya karma is considered a prime treatment modality in all types of Shiroroga (Headache) and also in Suryavar- tha (Frontal Sinusitis). Suryavartha (Frontal Sinusitis) is one of the 11 types of Shiroroga. It is one of the com- mon clinical conditions found in day to day general as well as Shalakya (ENT) practice. It presents with headache as one of its cardinal features and its occurrence is found in both genders and in all age groups. Objective: To study the efficacy of Shireeshadi Avapeedana Nasya in the management of Suryavartha (Frontal Sinusitis). Ma- terial methods: Twenty patients of Suryavartha (Frontal Sinusitis) were diagnosed and registered for the clinical study irrespective of sex, socio-economic status, and religion. The study was divided into two groups - Group A and Group B. Group – A patients were treated with Shireeshadi Avapeedana Nasya for 7 days and Group – B patients were treated by Nasya with milk for 7 days. Observation and result: Among 20 patients of Suryavartha / frontal sinusitis, 20 (100%) of patients had headache, 11 (55%) had nasal blockage, 05 (25%) had nasal dis- charge, 08 (40%) had foul smell in their breath and 14 (70%) have variations from normal X-Ray. The severity of headache is significantly reduced after treatment in both Groups A and B (92.95% and 73.07%) respectively. Conclusion: Administration of Shireeshadi Avapeeda Nasya showed statistically significant improvement in the management of Suryavartha (Frontal Sinusitis). Keywords: Suryavartha, Nasya, Shireeshadi Avapeedana Nasya, Frontal Sinusitis, Shigru, Mulaka, Ksheera.

scholarly journals A prospective study of the prevalence of Kuhn’s frontal cells and their relation to frontal sinus disease

2019 ◽  
Vol 5 (5) ◽  
pp. 1249
Author(s):  
Raam Deepak Krishnasamy ◽  
Karthikeyan Padmanabhan
Keyword(s):  
Frontal Sinus ◽  
Tertiary Care ◽  
Signs And Symptoms ◽  
P Value ◽  
Transverse Diameter ◽  
Frontal Sinusitis ◽  
Tertiary Care Centre ◽  
High Resolution Computed Tomography ◽  
Sinus Disease ◽  
Frontal Recess

<p class="abstract"><strong>Background:</strong> The involvement of frontal cells in the frontal sinus disease pathology remains an understudied area. There are very few reports on the prevalence of frontal recess cells in India. In this context the present study was designed to determine the frequency of occurrence of Kuhn frontal cells and to determine whether the size of the frontal isthmus or the presence of frontal cells is related to the presence of frontal sinus disease.</p><p class="abstract"><strong>Methods:</strong> This study included 80 patients who presented with signs and symptoms of chronic rhino-sinusitis after satisfying the inclusion criteria to the Department of ENT in a tertiary care centre (Mahatma Gandhi Medical College and Research Institute) in Pondicherry from January 2017 to April 2018. The patients were subjected to detailed clinical history, basic preoperative blood investigations, diagnostic nasal endoscopy and High Resolution Computed Tomography of nose and para-nasal sinuses after which the diagnosis was established.</p><p class="abstract"><strong>Results:</strong> Out of the 80 study participants subjected to our study the number of individuals who had frontal sinusitis was 50%. The association between frontal sinusitis and Kuhn cells was insignificant. The mean value of anteroposterior diameter of the naso-frontal isthmus in case of patients with and without frontal sinusitis was 0.705-0.735. In case of transverse diameter it was 0.725-0.720 and in case of the area of the frontal isthmus it was 30.86-31.12 which had a p value of 0.49</p><p><strong>Conclusions:</strong> Therefore in our study we concluded that there is no significant relation for any particular frontal recess cell or the size of the nasofrontal isthmus for being the sole cause for chronic frontal sinusitis.</p>

The clinical significance and optimal timing of postoperative computed tomography following cranial surgery

2010 ◽  
Vol 113 (5) ◽  
pp. 1021-1025 ◽  
Author(s):  
Ahmad Khaldi ◽  
Vikram C. Prabhu ◽  
Douglas E. Anderson ◽  
Thomas C. Origitano
Keyword(s):  
Neurological Deficit ◽  
Ct Scans ◽  
Optimal Time ◽  
Optimal Timing ◽  
Head Ct ◽  
Group A ◽  
Group B ◽  
Unexpected Findings ◽  
Over Time

Object This study was conducted to evaluate the value of postoperative CT scans in determining the probability of return to the operating room (OR) and the optimal time to obtain such scans to determine the effects of surgery. Methods Between January and December 2006 (12 months), all postoperative head CT scans obtained for 3 individual surgeons were reviewed. Scans were divided into 3 groups, which were determined by the preference of each surgeon: Group A (early scans—scheduled between 0 and 7 hours); Group B (delayed scans—scheduled between 8 and 24 hours); and Group C (urgent scans—ordered because of a new neurological deficit). The initial scans were reviewed and analyzed in 2 different fashions. The first was to analyze the efficacy of the scans in predicting return to the OR. The second was to determine the optimal time for obtaining a scan. The second analysis was a review of serial postoperative scans for expected versus unexpected findings and changes in the acuity of these findings over time. Results In 251 (74%) of 338 cases, the patients had postoperative head CT scans within 24 hours of surgery. Analysis 1 determined the percent of patients returning to the OR for emergency treatment based on postoperative scans: Group A (early)—133 patients, with 0% returning to the OR; Group B (delayed)—108 patients, with 0% returning to the OR; and Group C (urgent)—10 patients, with 30% returning to the OR (p < 0.05). Analysis 2 determined the optimal timing of postoperative scans and changes in scan acuity: Group A (early scan) had an 11% incidence of change in acuity on subsequent scans. Group B (delayed scan) had a 3% incidence of change in acuity on follow-up scans (p < 0.05). Conclusions Routine postoperative scans at 0–7 hours or at 8–24 hours are not predictive of return to the OR, whereas patients with a new neurological deficit in the postoperative period have a 30% chance of emergency reoperation based on CT scans. In addition, early postoperative scans (0–7 hours) fail to predict CT changes, which might evolve over time and may influence postoperative medical management.

The Intersinus Septal Cell: Anatomic, Radiologic, and Clinical Correlation

1996 ◽  
Vol 10 (5) ◽  
pp. 299-302 ◽  
Author(s):  
Robert M. Merritt ◽  
John P. Bent ◽  
Frederick A. Kuhn
Keyword(s):  
Computed Tomography ◽  
Frontal Sinus ◽  
Sinus Surgery ◽  
Ct Scans ◽  
Detailed Knowledge ◽  
Type I ◽  
Type Ii ◽  
Frontal Sinusitis ◽  
Clinical Correlation ◽  
Modern Era

Functional endoscopic frontal sinus surgery requires detailed knowledge of intranasal anatomy. Occasionally frontal sinusitis involves the intersinus septal cell (ISSC), which has not been described in the modern era of nasal endoscopy and computed tomography (CT). To study the ISSC, we reviewed 300 CT scans: 200 clinical and 100 cadaveric. We found ISSC in 70 (35%) of clinical scans, with six subjects having multiple ISSC. The cadaveric prevalence was slightly less at 31%. We further classified the ISSC according to the following criteria: type I, enclosed completely within the thin intersinus septum or bridging its entire inferior-superior extent; type II, bordered partially by this thin septum and partially by the thick septal base formed by the nasofrontal bone; type III, enclosed completely within the nasofrontal bone, often extending between frontal recesses rather than the actual sinuses. This report supplements our radiologic ISSC analysis with our experiences in five clinical cases.

The Frontal Cell as a Cause of Frontal Sinus Obstruction

1994 ◽  
Vol 8 (4) ◽  
pp. 185-192 ◽  
Author(s):  
John P. Bent ◽  
Carlos Cuilty-Siller ◽  
Frederick A. Kuhn
Keyword(s):  
Frontal Sinus ◽  
Mucociliary Clearance ◽  
Type I ◽  
Frontal Sinusitis ◽  
Cell Type ◽  
Radiographic Images ◽  
Frontal Recess ◽  
Sinus Cavity

The frontal cell is a rare anatomic anomaly that can become the etiology of chronic frontal sinusitis. It is an anterior ethmoid cell that can be differentiated from other ethmoid cells by serial analysis of sinus CT scans. Located cephalad to the middle meatus, it may obstruct natural mucociliary clearance by impinging on the frontal recess or the frontal sinus cavity. A classification of 4 types frontal cell (Type I-IV) is described. This anatomy is demonstrated in radiographic images of cadaver and patient sinuses. Four consecutive clinical cases of frontal cell obstruction of the frontal sinus are reviewed. In three instances, we performed a combined external and endoscopic intranasal frontal sinusotomy to effectively relieve the obstruction. We describe this technique in detail and provide a mean follow-up of 6 months for these four patients. With recognition of frontal cell obstruction of the frontal sinus, and proper treatment, the results appear to be very rewarding.

The Correlation between Ciliary Ultrastructure and Ciliary Beat Frequency in Experimental Chronic Sinusitis

1998 ◽  
Vol 12 (5) ◽  
pp. 317-324 ◽  
Author(s):  
Judith M. Czaja ◽  
Thomas V. McCaffrey
Keyword(s):  
Chronic Sinusitis ◽  
Beat Frequency ◽  
Ciliary Beat Frequency ◽  
Mucociliary Transport ◽  
Middle Meatal Antrostomy ◽  
Before And After ◽  
Group A ◽  
Group B ◽  
Ciliary Ultrastructure ◽  
Ciliary Beat

Ciliary ultrastructural abnormalities secondary to chronic sinusitis may cause abnormal mucociliary transport clearance. We examined the relationship between anatomic abnormalities of ciliary ultrastructure secondary to chronic sinusitis and ciliary beat frequency (CBF) before and after middle meatal antrostomy (MMA) in rabbits. Ultrastructural abnormalities of cilia included absence of axoneme membrane, blebs of the axoneme membrane, compound cilia, and ciliary orientation. Two groups of rabbits were studied: Uninfected (group A control, n = 3) and infected (group B, n = 10); 108 CFU S. pneumoniae were used to infect the animals in group B after sinus ostial occlusion and chronic sinusitis developed. After 6 weeks with infection, 6 of 10 group B animals underwent MMA and were restudied 6 weeks later. Uninfected animals had mean CBF = 11.75 Hz. Animals with chronic sinusitis had mean CBF = 8.5 Hz (p < 0.05). Six weeks after MMA, mean CBF = 11.82 Hz. This was not different from control. There were significant changes in ciliary ultrastructure when uninfected and infected rabbits were compared. These changes were reversed with MMA. Changes in ciliary ultrastructure correlated significantly with changes in CBF for all animals. Abnormalities in ciliary ultrastructure may account for the abnormal mucociliary transport clearance seen in chronic sinusitis in rabbits.

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