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

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.