الفهرس 
Developmental Anatomy Of Frontal SinusOnly 14 pages are availabe for public view
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Abstract
The anatomy of paranasal sinuses is complex and in many circumstances confusing. The anatomical variants of the sinonasal cavity impose a further challenge due to their further complexity and various types and forms. Frontal sinus anatomy can be challenging even for the most experience surgeon. A thorough knowledge of the most common normal variants is critical in order to safely navigate through the nose during endoscopic sinus surgical procedures and avoid complications. A series of “accessory” ethmoidal cells may line the frontal sinus outflow tract along the frontal recess, which are collectively known as frontal recess cells. These cells are normal anatomic variants that are present in some combination in most individuals. They not only can alter the normal sinus drainage if inflammatory conditions are present, but also if an endoscopic surgeon not aware of these cells this might result in a surgical failure. The frontal sinus can also be confused with the frontal recess cells. These represent a series of anterior ethmoidal cells directly superior to the agger nasi cell, coursing along the anterior wall of the frontal outflow tract. The most accepted classification of frontal recess cells was adopted by Kuhn and modified by Wormald. These frontal recess cells include agger nasi cell, supra-orbital ethmoidal air cell (SOEC), frontal cells (type 1-4), frontal bulla cell, supra-bullar cell, and interfrontal sinus septal cell. MDCT has become a useful diagnostic modality in the evaluation of the paranasal sinuses and an integral part of surgical planning. Today, MDCT is the radiologic examination of choice in evaluating the paranasal sinuses of a patient with sinusitis. The purpose of the current study focused on the assessment of the prevalence of different anatomical types of the frontal air cells and its effect on the occurrence and severity of the frontal sinusitis. The study was conducted on 50 patients with chronic frontal sinusitis either isolated or with other sinus affection, each case had 2 sides (right and left). Each side was considered as a separate entity and included 32 males and18 females, the age of patients ranged between 18 and 65 years, with a mean of 38.5 years. The prevalence of agger nasi cells was 91 sides (91%), In group A was 27 sides (90%) and In group B was 64 sides (91.4),the prevalence of Type I frontal cell was 28 sides (28%) In group A was 7 sides (23.3%) and in group B was 21 sides (30%),the prevalence of Type II frontal cell was 11 sides (11%)In group A was 3 sides (10%) and In group B was 8 sides (11.4%), the prevalence of Type III frontal cell was 21 sides (21%)In group A was 6 sides (20%) and In group B was 15 sides (21.4 ),the prevalence of Type IV frontal cell was 1 sides (1%) In group A was no sides (0%) and In group B was 1 side (1.4%),the prevalence of Supra orbital cell was 24 sides (24%), In group A was 2 sides (6.7%) and In group B was 22 sides (31.4%),the prevalence of Supra bullar cell was 31 sides (31%) In group A 5 sides (16.7%) and In group B was 26 sides (37.1%) %), the prevalence of Frontal bullar cell was 11 sides (11%) In group A was 2 sides (6.7%) and In group B was 9 sides (12.9%),the prevalence of Intersinus Septal cell was 10 sides (10%) In group A was 3 sides (10%) and in group B was 7 sides (10%). There were no significant difference between presence or absence of Agger nasi cell, frontal cell Type I, Type II, Type III, Type IV, frontal bullar cell and Intersinus Septal cell on occurrence of frontal sinusitis. (p-value >0.05). There was significant difference between presence and absence of Supra bullar cell and Supra orbital cell on occurrence of frontal sinusitis. (p-value <0.05).