Frontal Sinus Variations and Prevalence of Frontal Recess Cells among Adult Egyptians: Computerized Tomography Study

Abstract Background: The frontal sinus is often considered as the most challenging area to approach in Functional Endoscopic Sinus Surgery (FESS). Considerable variations in the shape, capacity and symmetry of frontal sinus have been reported. Aim of Study: To provide better understanding of frontal sinus morphometry and anatomical variations of specific frontal recess cells and their prevalence among adult Egyptians. Material and Methods: Coronal and sagittal CT scans of sixty adult persons of the Egyptian population (30 males and 30 females, assigned into Group 1; from 20 to 30 years, group 2; from 31 to 50 years and group 3; more than 50 years) were done to demonstrate the anatomy of the frontal sinus. Results: A statistically significant difference in the width of the right sinus between group 2 and group 3 was revealed. Eighty percent of frontal sinuses were asymmetrical. Agger nasi cell was the most common encountered frontal recess cell and mostly bilateraly presented. The second common was Interfrontal sinus septal cell (IFSC). Statistically significant association was found between Fronta Bullar Cell (FBC) and frontal cell type 4 (FC4) but no statistically significant differ-ence was found between males and females except for frontal cell type 3 (FC3) which was higher among females than males. Statistically significant positive correlation between A-P length of left FR and AP length of right FR was revealed, while no significant correlation was found between AP length and volume of ANC. Conclusion: Awareness of frontal sinus dimensions frontal recess cells variations among Egyptians should be taken in consideration in safe frontal endoscopic surgery.