The Relationship Between Frontal Sinusitis and Localization of the Frontal Sinus Outflow Tract: A Computer-Assisted Anatomical and Clinical Study | Otolaryngology | JAMA Otolaryngology–Head & Neck Surgery | JAMA Network
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1.
Kuhn  FA Chronic frontal sinusitis: the endoscopic frontal recess approach.  Oper Techn Otolaryngol Head Neck Surgery 1996;7222- 229Google ScholarCrossref
2.
Jacobs  JB 100 years of frontal sinus surgery.  Laryngoscope 1997;107(11 pt 2)1- 36PubMedGoogle ScholarCrossref
3.
McLaughlin  RBRehl  RMLanza  D Clinically relevant frontal sinus anatomy and physiology.  Otolaryngol Clin North Am 2001;341- 22PubMedGoogle ScholarCrossref
4.
Landsberg  RFriedman  M A computer-assisted anatomical study of the nasofrontal region.  Laryngoscope 2001;1112125- 2130PubMedGoogle ScholarCrossref
5.
Schaeffer  JP The genesis, development, and adult anatomy of the nasofrontal region in man.  Am J Anat 1916;20125- 143Google ScholarCrossref
6.
Isobe  MMuracani  GKataura  A Variations of the uncinate process of the lateral nasal wall with clinical implications.  Clin Anat 1998;11295- 303PubMedGoogle ScholarCrossref
7.
Yoon  JHKim  KSJung  DH  et al.  Fontanelle and uncinate process in the lateral wall of the human nasal cavity.  Laryngoscope 2000;110281- 285PubMedGoogle ScholarCrossref
8.
Stammberger  HHawke  M Functional Endoscopic Sinus Surgery.  Philadelphia, Pa: BC Decker Publishers; 1991
9.
Friedman  MLandsberg  RSchults  RA  et al.  Frontal sinus surgery: endoscopic technique and preliminary results.  Am J Rhinol 2000;14393- 403PubMedGoogle ScholarCrossref
10.
Kennedy  DWSenior  BA Endoscopic sinus surgery: a review.  Otolaryngol Clin North Am 1997;30313- 330PubMedGoogle Scholar
11.
Jacobs  JBLebowitz  RASorin  A  et al.  Preoperative sagittal CT evaluation of the frontal recess.  Am J Rhinol 2000;1433- 37PubMedGoogle ScholarCrossref
12.
Kim  KSKim  HUChung  IH  et al.  Surgical anatomy of the nasofrontal duct: anatomical and computed tomographic analysis.  Laryngoscope 2001;111603- 608PubMedGoogle ScholarCrossref
13.
Kasper  KA Nasofrontal connection, a study based upon 100 consecutive cadaver dissections.  Arch Otolaryngol 1936;23322- 343Google ScholarCrossref
14.
Gaafar  HAbdel-Monem  MHQavas  MK Frontal sinus outflow tract “Anatomic study.”  Acta Otolaryngol 2001;121305- 309PubMedGoogle ScholarCrossref
15.
Lee  DBrody  RHar-El  G Frontal sinus outflow anatomy.  Am J Rhinol 1997;11283- 285PubMedGoogle ScholarCrossref
16.
Messerklinger  W On the drainage of the normal frontal sinuses of man.  Acta Otolaryngol (Stockh) 1967;63176- 181PubMedGoogle ScholarCrossref
17.
Rudack  CSachse  FAlberty  J Chronic rhinosinusitis—need for further classification?  Inflamm Res 2004;53111- 117PubMedGoogle ScholarCrossref
Original Article
June 2005

The Relationship Between Frontal Sinusitis and Localization of the Frontal Sinus Outflow Tract: A Computer-Assisted Anatomical and Clinical Study

Arch Otolaryngol Head Neck Surg. 2005;131(6):518-522. doi:10.1001/archotol.131.6.518
Abstract

Objective  To evaluate the relationship between frontal sinusitis and the localization of the frontal sinus outflow tract medial or lateral to the superior attachment of the uncinate process (UP).

Design  A retrospective anatomical and clinical study.

Setting  An ear, nose, and throat clinic in işli Etfal Teaching and Research Hospital, Istanbul, Turkey.

Patients  Paranasal sinus computed tomographic scans of 486 sides of the frontal sinuses (hereafter referred to as sides) of 243 patients who had chronic sinusitis were evaluated. In 125 sides (26%), the superior attachment of the UP could not be identified. In the remaining 361 sides (74%), the prevalence of superior attachment of UP types and the presence of frontal sinusitis in each side were recorded. Localization of the frontal sinus outflow tract was determined according to the superior attachment of the UP. Drainage of the frontal sinus to the middle meatus (medial to the superior attachment of the UP [types 1-3]) was classified as group 1, and drainage of the frontal sinus to the ethmoid infundibulum (lateral to the superior attachment of the UP [types 4-6]) was classified as group 2.

Results  Frontal sinusitis was found in 125 (35%) of 361 sides. The distribution of frontal sinusitis was 97 (41%) of 237 in group 1 and 28 (23%) of 124 in group 2. Group 1 drainage had a statistically significant presence of frontal sinusitis (χ2 = 12.11; P<.001). The prevalence of superior attachment of UP types was 63% for type 1/2, 3% for type 3, 12% for type 4, 14% for type 5, and 8% for type 6.

Conclusions  Frontal sinus outflow tract, which is medial to the superior attachment of the UP, is more common than the lateral one. There is a statistically significant relation between the presence of frontal sinusitis and the frontal sinus outflow tract, which is medial to the superior attachment of the UP.

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