Study of Anatomical Variations of the Frontal Sinus by Computed Tomography Scans of Egyptians

Background: A great interest has been paid toward the anatomic variations of frontal sinus (FS) and frontal recess (FR). The international frontal sinus anatomy classification (IFAC) has by time attained a growing popularity being a novel and simple classification of frontal recess cells (FRCs). Objective: This study aimed to provide better understanding of FS morphometry and anatomic variations of FRCs and their prevalence among Egyptian adults using computed tomography (CT). Patients and methods: We enrolled 500 adult Egyptian patients in this study. The medical records and CT studies of the cases were reviewed to assess their demographic data and the pattern of frontal sinus as appeared in the radiological findings. Frontal sinus classification was described using the IFAC. Results: Regarding the IFAC, agger nasi cells (ANCs) were found in 97.8%, supra agger cells (SACs) in 50.4%, supra Agger frontal cells (SAFCs) in 24%, supra bulla cells (SBCs) in 87.8%, supra bulla frontal cells (SBFCs) in 26.2%, supraorbital ethmoidal cells (SOECs) in 9.4% and frontal septal cells (FSCs) in 27.6% of cases. Regarding the frontal sinus’s size, aplasia was detected in 11 cases (2.2%), hypoplasia in 36 cases (7.2%) and hyperplasia in 105 (21%), while the large percent of the cases had medium sized sinuses (69.6%). Conclusion: ANCs were the most prevalent cells. Occurrence of IFAC cells was closely related to that found in our study. High-resolution CT scans can delineate the FRCs, which is important for preoperative assessment and treatment of pathologies related to the FS.