Incidence of frontal sinus aplasia in Indian population
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20164811Keywords:
Frontal sinus, Aplasia, FESS, Paranasal sinus, Skull baseAbstract
Background: Aplasia or agenesis of frontal sinuses is not uncommon in the literature. Previous studies have shown unilateral aplasia varying from 1-10% and bilateral agenesis of frontal sinus in 3-10% of patients. It is critical for the operating surgeon to be well aware of the normal anatomy and the variations while doing procedures like endoscopic sinus surgeries, cranialisation of frontal sinuses, frontal sinus trephination, and during anterior skull base procedures. The aim of this study is to demonstrate the incidence of anatomic variations of frontal sinus among Indian populations.
Methods: We did a cross sectional study on computed tomography (CT) scan of head, nose and paranasal sinuses in 730 patients above the age of 10 years. We excluded pregnant ladies, patients with prior sinus surgeries, sinonasal tumors, nasal polyposis, craniofacial trauma.
Results: We observed an incidence of 6.2% of unilateral aplasia of frontal sinus (2.2% in males and 4.0% in females, 3.7% right side and 2.5% left side) and 2.5% of bilateral frontal sinus aplasia (0.95% in males and 1.5% in females).
Conclusions: Frequent occurrence of frontal sinus aplasia highlights the need to gain a thorough knowledge of the normal anatomy and its variations in order to navigate safely through the nose during basic endoscopic sinus or anterior skull base surgeries to avoid complications.
References
Levine HL, Clemente MP. Sinus surgery: endoscopic and mi-croscopic approaches. In: Clemente MP, editor. Surgical Anatomy of the Paranasal Sinus. Stuttgart: Thieme; 2003: 1-55.
Landsberg, Roee, Friedman, Michael. A Computer-Assisted Anatomical Study of the Nasofrontal Region. Laryngoscope. 2001;111:2125-30.
Aydinlioðlu A, Kavakli A, Erdem S. Absence of Frontal Sinus in Turkish Individuals. Yonsei Med J. 2003;44:215-8.
Duque CS, Casiano RR. Surgical Anatomy and Embryology of the Frontal Sinus. In: Kountakis S, Senior BA, Draf W, editors. The Frontal Sinus. Springer; 2005.
Cryer MH. Some variations in the frontal sinuses. J American Med Asso. 1907;26;48(4):284-9.
Choudhary S, Pasricha N, Sehgal G, Siddiqui MS, Khanduri S, Srivastava MR, et al. Aplasia of Frontal Sinus: CT Study. Int J Anat Res. 2015:3(4):1620-3.
Nowak R, Mehls G. Die apllasien der sinus maxillaries und frontales unter besenderer Berucksichtigung der pneumatization bei spalttragern. Anat Anz. 1977;142:441-50.
Çakur B, Sumbullu MA, Durna NB. Aplasia and agenesis of the frontal sinus in Turkish individuals: a retrospective study using dental volumetric tomography. In J Med Sci. 2011;8(3):278.
Yoshino M, Miyasaka S, Sato H, Seta S. Classification system of frontal sinus patterns by radiography. Its application to identification of unknown skeletal remains. Forensic Sci Int. 1987;34:289-99.
Schuller A. Note on the identification of skulls by X-ray pictures of the frontal sinuses. Med J Aust. 1943;1:554-6.