Nair Preethi P, Varghese Ashish, Kumar Navneet, Varghese Sunil Sam
Department of E.N.T, Chrisitan medical college, Ludhiana, Punjab India.
Indian J Otolaryngol Head Neck Surg. 2024 Aug;76(4):3451-3457. doi: 10.1007/s12070-024-04724-6. Epub 2024 Apr 26.
International frontal sinus anatomy classification (IFAC) was introduced in 2016 to standardize the nomenclature of the cells in the frontal recess region, facilitate better communication between surgeons and precision in surgical planning, and improve surgical teaching. This study aims to estimate the radiological prevalence of the different frontal recess cells according to the IFAC and to evaluate the relationship of these cells with the frontal sinus opacification in patients with chronic rhinosinusitis.
In this study, 90 participants diagnosed with chronic rhinosinusitis (CRS) who underwent computed tomogram (CT) of the para nasal sinuses were enrolled consecutively. The CT images were were studied in detail using RadiAnt DICOM viewer. The frontal recess cells were grouped as per the IFAC guidelines and their respective prevalence was calculated. The frontal recess cells were grouped as per the Opacification or mucosal thickening within these cells and the frontal sinuses were noted. A multivariate logistic regression analysis was done to evaluate the association between frontal sinus opacification and presence of various IFAC cells.
A total of 640 IFAC cells were documented in 180 sides, of which 326 were anterior cells, 263 were posterior cells and 51 were medial cells. The most prevalent cell was the agger nasi cells(ANC), present in 91.7% of 180 sides, the supra agger nasi cells(SANC), Supra agger nasi frontal cells(SAFC), supra bulla cells(SBC), supra bulla frontal cells(SBFC), supra orbital ethmoidal cells(SOEC) and frontal septal cells(FSC) were present in 47.8%,37.8%, 65.6%,28.9%, 51.1% and 28.3% respectively. There was no significant association of presence of IFAC cells and frontal sinus opacification except for SBFC( = 0.038). A significantly higher number of diseased frontal recess cells were seen with involved frontal sinuses when compared with non-involved frontal sinuses across all types of IFAC cells.
The ANC were the most prevalent among all the IFAC cells and the FSC were the least prevalent. There was no significant association with the presence of different types of IFAC cells and frontal sinus opacification except for SBFC. However, there was a significantly higher number of diseased IFAC cells associated with frontal sinus opacification than in those without frontal sinus opacification.
国际额窦解剖分类（IFAC）于2016年推出，旨在规范额隐窝区域气房的命名，促进外科医生之间更好的交流以及手术规划的精确性，并改善外科教学。本研究旨在根据IFAC评估不同额隐窝气房的放射学患病率，并评估这些气房与慢性鼻窦炎患者额窦混浊的关系。
在本研究中，连续纳入90例诊断为慢性鼻窦炎（CRS）并接受鼻窦计算机断层扫描（CT）的参与者。使用RadiAnt DICOM Viewer详细研究CT图像。根据IFAC指南对额隐窝气房进行分组，并计算其各自的患病率。根据这些气房内的混浊或黏膜增厚情况对额隐窝气房进行分组，并记录额窦情况。进行多因素逻辑回归分析以评估额窦混浊与各种IFAC气房存在之间的关联。
在180侧共记录到640个IFAC气房，其中326个为前组气房，263个为后组气房，51个为内侧气房。最常见的气房是鼻丘气房（ANC），在180侧中的91.7%存在，鼻丘上气房（SANC）、鼻丘上额气房（SAFC）、泡上气房（SBC）、泡上额气房（SBFC）、眶上筛气房（SOEC）和额中隔气房（FSC）的存在率分别为47.8%、37.8%、65.6%、28.9%、51.1%和28.3%。除SBFC外（P = 0.038），IFAC气房的存在与额窦混浊无显著关联。与未受累的额窦相比，在所有类型的IFAC气房中，受累额窦中可见明显更多的病变额隐窝气房。
在所有IFAC气房中，ANC最为常见，FSC最不常见。除SBFC外，不同类型的IFAC气房的存在与额窦混浊无显著关联。然而，与无额窦混浊的情况相比，与额窦混浊相关的病变IFAC气房数量明显更多。
