전두와의 해부학적 변이와 전두동염:부비동 전산화단층촬영을 이용한 분석

우현재,예상백,배창훈,송시연,김용대 대한비과학회 2009 Journal of rhinology Vol.16 No.1

Background and Objectives:The frontal recess (FR) cells, including the frontal cell (FC), agger nasi cell (ANC), supraorbital ethmoid cell (SOC) and inter-frontal sinus septal cell (IFSSC), can interfere with the drainage system of the frontal sinus. We evaluated the relationship between the FR cells and the frontal sinusitis. Subjects and Methods:All paranasal sinus CT scans performed from July 2004 through June 2005 were reviewed. Of the 675 scans reviewed, 317 patients (634 sides) were selected for data collection. Exclusion criteria included a clinical history of neoplasms, bony deformities, and extensive disease responsible for obscuring the bony anatomy. Similarly, CT scans with severe artifacts were also excluded. Result:FCs were present in 21.9% of the patients. According to the Bent’s classification, the prevalence of each FC type was as follows; type 1 FC (13.6%), type 2 FC (3.2%), type 3 FC (1.9%) and type 4 FC (3.1%). Of the four types of FR cells, type 4 had a significant association with frontal sinusitis. The incidence of hyperpneumatized frontal sinus, ANC, SOC, IFSSC were significantly higher among patients with the FC than those without the FC (p<0.05). Patients without the ANC or with type 1 uncinate process, according to Stammberger’s classification, displayed a higher frequency of frontal sinusitis (p<0.05). There was a statistically significant decrease in the frequency of frontal sinusitis among patients with hypopneumatized frontal sinus (p<0.05). Conclusion:In our series, the frontal sinusitis was influenced by each types of FC, attachment sites of uncinate process and the degree of frontal sinus pneumatization. Therefore, these anatomic variations in the frontal recess should be appropriately addressed during the surgical management of the frontal sinusitis. Background and Objectives:The frontal recess (FR) cells, including the frontal cell (FC), agger nasi cell (ANC), supraorbital ethmoid cell (SOC) and inter-frontal sinus septal cell (IFSSC), can interfere with the drainage system of the frontal sinus. We evaluated the relationship between the FR cells and the frontal sinusitis. Subjects and Methods:All paranasal sinus CT scans performed from July 2004 through June 2005 were reviewed. Of the 675 scans reviewed, 317 patients (634 sides) were selected for data collection. Exclusion criteria included a clinical history of neoplasms, bony deformities, and extensive disease responsible for obscuring the bony anatomy. Similarly, CT scans with severe artifacts were also excluded. Result:FCs were present in 21.9% of the patients. According to the Bent’s classification, the prevalence of each FC type was as follows; type 1 FC (13.6%), type 2 FC (3.2%), type 3 FC (1.9%) and type 4 FC (3.1%). Of the four types of FR cells, type 4 had a significant association with frontal sinusitis. The incidence of hyperpneumatized frontal sinus, ANC, SOC, IFSSC were significantly higher among patients with the FC than those without the FC (p<0.05). Patients without the ANC or with type 1 uncinate process, according to Stammberger’s classification, displayed a higher frequency of frontal sinusitis (p<0.05). There was a statistically significant decrease in the frequency of frontal sinusitis among patients with hypopneumatized frontal sinus (p<0.05). Conclusion:In our series, the frontal sinusitis was influenced by each types of FC, attachment sites of uncinate process and the degree of frontal sinus pneumatization. Therefore, these anatomic variations in the frontal recess should be appropriately addressed during the surgical management of the frontal sinusitis.

전두동 개구부 봉소가 전두동염의 발생에 미치는 영향

정주환,진봉준,정진혁,조석현,이승환,김경래 대한이비인후과학회 2012 대한이비인후과학회지 두경부외과학 Vol.55 No.11

Background and Objectives Frontal recess anatomy can be very complex, with accessory cells extending to the frontal sinus and possibly contributing to the obstruction of the frontal sinus. However, there is still controversy on the effect of the frontal recess cells. We designed this study to assess the effect of frontal recess cells on frontal sinusitis. Subjects and Method We retrospectively reviewed chart and collected data of those who visited the outpatient clinic between January and June, 2011. Parnasal sinus CT was taken with Brillance 64-slice computed tomography scanners. The image was reviewed by two or more otolaryngologists to identify the frontal recess cells. The nasofrontal isthmus diameter and the area of nasofrontal isthmus was reconstructed and measured with workstation. Then, we compared the radiological results of frontal recess cells with the frequency of frontal sinusitis. Results The presence of anterior group of frontal recess cells showed no influence on the frontal recess anatomy. The presence of frontal bullar cell was significantly associated with the development of frontal sinusitis by simple (p=0.001) and multiple (p=0.038) logistic regression models. It was shown that the narrower the area of frontal isthmus the more developed were the frontal sinusitis, showing statistically significance in the simple (p=0.013) and multiple (p= 0.017) logistic regression models. Conclusion Our results also showed that similar results compared to previous Asianreport. The narrowness of nasofrontal isthmus could be the cause of frontal sinusitis. The frontal bullar cell could be the cause of frontal sinusitis encroaching on the frontal recess and affect the nasofrontal pathway.

Distribution of frontal sinus pattern amongst Malaysian population: a skull radiograph study

Nur Damia Iwani Zulkiflee,Mansharan Kaur Chainchel Singh,Aspalilah Alias,Helmi Mohd Hadi Pritam,Eric Chung,Rani Sakaran,Nurul Hannim Zaidun,Choy Ker Woon 대한해부학회 2022 Anatomy & Cell Biology Vol.55 No.3

Frontal sinus has unique anatomical features that are distinct to every population. However, the distribution of frontal sinus patterns has yet to be explored in the Malaysian population. This study aimed to describe the distribution of frontal sinus patterns among adult Malaysians. 409 adult Malaysian posteroanterior skull radiographs, consisting of 200 males and 209 females of Malay, Chinese, and Indian races aged between 20–69 years old, were included in the study. The frontal sinus patterns were classified according to total and percentage of presence or absence of frontal sinus, symmetry or asymmetrical (right or left dominant), unilateral absence (right or left), bilateral absence, and lobulation. The findings showed that bilateral presence of frontal sinus is common, in 95.4% of individuals and bilateral absence was noted in 2.7% individuals. Unilateral absence was found in 2.0% of individuals. Asymmetrical frontal sinus was observed in 54.5% of population meanwhile 40.8% showed symmetrical frontal sinus. The majority of individuals, regardless of sex, race, and age, possessed 1 to 3 lobes on both sides of the frontal sinus. The findings suggest that the frontal sinus is highly asymmetric, and the absence of the frontal sinus is rare. This morphological variation provides an insight into the landmarking placement for measurement during forensic application and assists neurosurgeons in surgical procedure to avoid breaching of the frontal sinus.

안와 합병증을 동반한 전두동에 국한된 진균성 부비동염 1예

이진,변남철,서민호,이시영 대한이비인후과학회 2005 대한이비인후과학회지 두경부외과학 Vol.48 No.2

The most commonly involved sinus of fungal infections is maxillary sinus, followed by sphenoid sinus and ethmoid sinus. On ecies of Aspergilus, dematiaceous fungi or zygomycetes; however, species of candida are rarely reported. In the invasive fungal sinusitis, orbital invasion, invasion and destruction of the skull base with a fungal meningitis, and fungal osteomyelitis with complete destruction of the maxilla have all ben reported. Although these ocurrences can not be explained, orbital complica-surgical removal. In the past, fungus ball of frontal sinus was approached externally; however, this has been largely replaced with the endonasal endoscopic technique. We experienced a case of frontal fungal sinusitis with orbital complication, which was sucesfuly treated by endonasal endoscopic frontal sinusotomy. In this paper, we report this case with a review of literature.

Frontoethmoidal Cells on Computed Tomographic Analysis: The Prevalence and Relationship to Frontal Sinus/Recess Mucosal Thickening

이승주,강현우,유광규 대한비과학회 2014 Journal of rhinology Vol.21 No.1

Objectives : To determine the prevalence of frontoethmoidal cells (FECs) in patients with and without frontal sinus/recess mucosal thickening and to establish the relationship between the FECs and the frontal sinus/recess mucosal thickening. Materials and Methods : We retrospectively reviewed 245 consecutive ostiomeatal CT scans (490 sides). The normal and frontal sinus/recess mucosal thickening groups were categorized based on these images. The latter group was sub-categorized into the frontal sinus mucosal thickening group (FS group) and the frontal recess mucosal thickening group (FR group). Results : Types 1, 2, 3 and 4 frontal cells were found in 17.5, 6.7, 8.3 and 0%of 326 normal sides, respectively. The prevalence of agger nasi, suprabullar, frontal bullar,supraorbital ethmoid and interfrontal sinus septal cells was 85.6, 43.3, 4.9, 4.3 and 17.2% of the same 326 normal sides, respectively. Type 3 frontal cells, frontal bullar cells and suprabullar cells were more prevalent in the FS and FR groups than in the normal group. All types of cells were more prevalent in the FS group, but only the suprabullar cells were more prevalent in the FR group than in the normal group. Conclusion : These findings suggest that type 3 frontal cells, frontal bullar cells and suprabullar cells may have a significant association with frontal sinus/recess mucosal thickening.

전두동에 국한된 진균성 부비동염 1예:내시경적 비내 접근법 및 전두동 소형 천공술을 이용한 치료

우영기,김민한,배창훈,김용대 대한비과학회 2009 Journal of rhinology Vol.16 No.1

The incidence and prevalence of human fungal sinusitis are increasing, because of recently increased immunocompromised host and developed diagnostic tool. Aspergillosis is the most common fungal infection of the paranasal sinuses. The maxillary sinus is most commonly affected by Aspergillus, followed by the sphenoid and ethmoid sinuses. However, isolated frontal fungal sinusitis is extremely rare. Recently, we experienced that a cases of Aspergillus sinusitis of isolated frontal sinus successfully was treated by endoscopic sinus surgery combined with frontal sinus minitrephination (the above and below approach). Therefore, we report this case with a review of the literatures. The incidence and prevalence of human fungal sinusitis are increasing, because of recently increased immunocompromised host and developed diagnostic tool. Aspergillosis is the most common fungal infection of the paranasal sinuses. The maxillary sinus is most commonly affected by Aspergillus, followed by the sphenoid and ethmoid sinuses. However, isolated frontal fungal sinusitis is extremely rare. Recently, we experienced that a cases of Aspergillus sinusitis of isolated frontal sinus successfully was treated by endoscopic sinus surgery combined with frontal sinus minitrephination (the above and below approach). Therefore, we report this case with a review of the literatures.

전두동 골절 14예의 임상적 고찰

권재환,홍순만,한창용,반정민,김기철,박기호,조중환 대한이비인후과학회 1998 대한이비인후과학회지 두경부외과학 Vol.41 No.5

한국인 성인에서의 전두동과 접형동의 함기화: 전산화단층촬영을 이용한 연구

심영창,강명신,유준상,이재훈 대한이비인후과학회 2018 대한이비인후과학회지 두경부외과학 Vol.61 No.7

Background and Objectives For safe sinus surgery, it is essential to understand the anatomicalstructure and developmental state of the paranasal sinuses. Structural abnormalies such asaplastic and marked hypoplastic sinuses may not be amenable to sinus surgery or balloonsinuplasty. The purpose of this study is to evaluate the degree of pneumatization of the frontaland sphenoid sinuses in Korean adults. Subjects and Method This retrospective study utilized CT images of 1190 sides from 595Korean adults. The frontal sinus was classified into normal, hypoplasia, aplasia and unilateralhidden aplasia. The sphenoid sinus was evaluated the incidence regarding the aplasia and unilateralhidden hypoplasia. Results Bilateral frontal sinus hypoplasia was observed in 8.5% of women and 4.2% of men(p<0.05), while unilateral frontal sinus hypoplasia was found in 3.5% of women and in 4.8%of men (p>0.05). Bilateral frontal sinus aplasia was observed in 7.1% of women and 2.9% ofmen (p<0.05), while unilateral frontal sinus aplasia were found in 7.1% of women and in 5.4%of men (p>0.05). Unilateral hidden frontal sinus aplasia was observed in 1.7% of women and1.5% of men (p>0.05). There was no bilateral sphenoid sinus aplasia and only one woman hadunilateral sphenoid sinus aplasia. Unilateral hidden sphenoid sinus hypoplasia was observedin 1.4% of women and 2.9% of men (p>0.05). Conclusion Bilateral frontal sinus hypoplasia and aplasia are more common in women thanin men. Although the incidences of unilateral hidden frontal sinus aplasia and hidden sphenoidsinus hypoplasia are low, sinus surgeons should carefully review CT for sinus surgery or balloonsinuplasty.

Three-dimensional linear and volumetric computed tomography analysis of the frontal sinus

Jung-Ah Park,Yeon-Ju Lee,In-Seung Yeo,Ki-Seok Koh,Wu-Chul Song 대한해부학회 2022 Anatomy & Cell Biology Vol.55 No.2

The frontal sinus is one of the four paranasal sinuses in humans, and knowledge of its anatomy is important when performing surgery involving the frontal bone or sinus. Although many studies have measured the frontal sinus using radiography and computed tomography (CT), few studies have evaluated by using three-dimensional (3D) analysis. The purpose of this study was to analyze the frontal sinus using 3D reconstruction analysis and determine the differences in linear and volumetric measurements between sexes, sides, and ages. The sample comprised 281 facial CT scans: 173 and 108 from males and females, respectively. The width, height, and length of each frontal sinus and total volume were all larger in males than in females. Almost all linear and volumetric measurements were larger in young adults than in older for both sexes, but not all of the differences were statistically significant. Linear and volumetric measurements were larger for males than females regardless of age group. There were no statistically significant differences between the right and left sides except the width in males. The size of the frontal sinus was strongly influenced by sex and age. The measurements reported here might be useful for improving surgical procedures involving the frontal sinus.

두개강화를 이용한 거대 전두동 골종의 치험례

김찬,정승문 대한성형외과학회 2002 Archives of Plastic Surgery Vol.29 No.6

Frontal sinus osteoma is one of the rare diseases and is diagnosed incidentally by skull X-ray. After the disease is confirmed, long term follow-up is necessary.The etiology of the disease is usually unknown and almost all of the patients has any kind of symptoms or signs. The most of the symptoms of this disease are pain, headache, swelling and lagophthalmos. Frontal sinus osteoma has characteristic features such as radiopaque, mass like lesion in the frontal sinus. Operation of the frontal sinus osteoma is not necessary unless it has symptoms or infection sign. We experienced one case and operated the osteoma and reconstructed frontal sinus by cranialization and bihalving calvarial bone graft. The result is satisfactory without complication.