Computed Tomographic Analysis of the Relationship between Frontal Recess Cells and Isolated Frontal Sinusitis

Objective: The relationship between frontal recess (FR) cells and frontal sinusitis is a topic of controversy. Numerous studies have explored this connection, but the majority have encompassed patients with frontal sinusitis in combination with chronic rhinosinusitis, with or without polyps. For a stronger causal link, it's crucial to focus on isolated frontal sinusitis (IFS), though primary IFS is exceptionally rare. This study aims to investigate the role of FR cells in the development of IFS. Methods: Two reviewers examined FR cells in triplanar computed tomography scans of 22 patients with 25 sides of IFS and 50 patients with healthy sinuses. The prevalence of each cell type was determined using the International Frontal Sinus Anatomy Classification (IFAC), and logistic regression analysis was used to determine whether any FR cells were associated with IFS. Results: Our results showed that supraorbital ethmoid cells (SOEC) (p <0.001) and supra agger frontal cells (p =0.038) were significantly more prevalent in the IFS group than in the control group. Logistic regression analysis revealed that the presence of SOEC was associated with a 4.79-fold greater risk of IFS (95% CI, 1.30–17.65, p =0.018). Conclusion: The FR cells may play a role in the development of frontal sinusitis. Among the IFAC cell types, SOEC appears to be associated with IFS.