Koliyote Snigdha Girish, Singh Rohit, Mary Mathew Neethu, K Prakashini
Department of Otorhinolaryngology & Head and Neck surgery, Kasturba Hospital Manipal, Manipal Academy of Higher Education, Manipal, Karnataka India.
Department of Radiodiagnosis and Imaging, Kasturba Hospital Manipal, Manipal Academy of Higher Education, Manipal, Karnataka India.
Indian J Otolaryngol Head Neck Surg. 2024 Feb;76(1):495-502. doi: 10.1007/s12070-023-04193-3. Epub 2023 Sep 1.
The frontal recess region has a complex anatomy and HRCT scans of the paranasal sinuses (PNS) are the gold standard in evaluating it. Classification systems have been established to identify the frontal recess cells. The objectives of this study are to describe the incidence of anatomical variations, classify the anatomy of the frontal recess using the IFAC & Kuhn's classification systems, find the association between the anatomical variations and the incidence of CT signs of sinusitis. A prospective study of patients undergoing HRCT-PNS was carried out. The frontal recess region was evaluated and classified as per both classification systems. The prevalence of each frontal cell was identified; presence of CT signs of sinusitis was noted and the correlation between the two was evaluated. 272 sides of HRCT scans were evaluated. Prevalence of cells as per IFAC classification showed ANC - 98.2%, SAC-43.4%, SBC-33.1%, SAFC- 28.3%, FSC -25%, SBFC- 3.7% and SOEC- 2.2%. Prevalence of cells as per Kuhn's classification showed ANC - 98.2%, Type 1- 38.2%, SBC-32.7%, FSC -24.3%, Type 3- 16.9%, Type 2- 12.9%, Type 4- 4.8%, FBC- 2.6% and SOEC-2.2%. Sinusitis was seen in 27.2% cases. A significant association was noted between the presence of SOEC, FSC and sinusitis as per both classification systems. (P=0.049 and P<0.001 respectively). In conclusion the cells which lead to an anteriorly based drainage pathway are more common, but the presence of posteriorly based SOEC and medially based FSC have a higher association with sinusitis.
额隐窝区域解剖结构复杂，鼻窦高分辨率CT（HRCT）扫描是评估该区域的金标准。目前已建立分类系统来识别额隐窝气房。本研究的目的是描述解剖变异的发生率，使用IFAC和库恩分类系统对额隐窝的解剖结构进行分类，找出解剖变异与鼻窦炎CT征象发生率之间的关联。对接受鼻窦HRCT检查的患者进行了一项前瞻性研究。根据两种分类系统对额隐窝区域进行评估和分类。确定每个额气房的患病率；记录鼻窦炎的CT征象，并评估两者之间的相关性。共评估了272侧HRCT扫描。根据IFAC分类，气房的患病率显示为：前组筛窦气房（ANC）-98.2%，筛泡气房（SAC）-43.4%，筛骨基板气房（SBC）-33.1%，筛漏斗气房（SAFC）-28.3%，额气房（FSC）-25%，筛板上气房（SBFC）-3.7%，筛骨眶上气房（SOEC）-2.2%。根据库恩分类，气房的患病率显示为：ANC-98.2%，1型-38.2%，SBC-32.7%，FSC-24.3%，3型-16.9%，2型-12.9%，4型-4.8%，额筛泡气房（FBC）-2.6%，SOEC-2.2%。27.2%的病例存在鼻窦炎。根据两种分类系统，均发现SOEC和FSC的存在与鼻窦炎之间存在显著关联（P值分别为0.049和P<0.001）。总之，导致前位引流途径的气房更为常见，但后位的SOEC和中位的FSC与鼻窦炎的关联更高。
