Incidence of agger nasi and frontal cells and their relation to frontal sinusitis in a Turkish population: a CT study

Year 2018, Volume: 12 Issue: 2, 71 - 75, 15.08.2018

Adnan Ozdemir Serdar Arslan

Abstract

Objectives: The aim of this study was to determine the incidence of agger nasi and frontal cells in a Turkish population and

their relation to frontal sinusitis.

Methods: A total of 412 non-contrast paranasal sinus computed tomography (CT) images taken between March 2017 and June

2018 were examined retrospectively. Frontal cells were classified into four types according to Kuhn’s classification. The relation

of agger nasi and frontal cells to frontal sinusitis was evaluated.

Results: Of the 412 patients, 202 were males (mean age 34.8±14.9) and 210 were females (mean age 35.1±13.9). agger nasi

cell was detected in 214 (51.9%), and frontal cell in 198 patients (48%). Frontal sinusitis was detected in 68 patients (16.5%).

According to Kuhn’s classification, Type 1 frontal cell was detected most frequently. A significant relationship was observed

between the presence of agger nasi and frontal cells and frontal sinusitis (p<0.001). When the right and left frontal sinusitis were

evaluated separately, the relationship of frontal cell types of Kuhn’s classification with frontal sinusitis was found to be significant

on the right side, but not on the left side.

Conclusion: Agger nasi and frontal cells are common paranasal sinus variations that play a role in the development of frontal

sinusitis. Although most of the paranasal sinus variationsare considered as predisposing in the development of sinusitis,

there are obvious differences in studies. For this reason, a higher number of comprehensive studies are necessary to reveal

the relation between the presence of agger nasi and frontal cells and sinusitis.

Keywords

Agger nasi cell, frontal cell, frontal sinusitis

References

• 1. Llyod GA, Lund VJ, Scadding GK. CT of paranasal sinuses and functional endoscopic surgery: a critical analysis of 100 symptomatic patients. J Larinygol Otol 1991; 105: 181-52. Lee WT, Kuhn FA, Citardi MJ. 3D computed tomographic analysis of frontal recess anatomy in patients without frontal sinusitis. Otolaryngol Head Neck Surg 2004; 131: 164-733. Bradley DT, Kountakis SE. The role of agger nasi air cells in patients requiring revision endoscopic frontal sinus surgery. Otolaryngol Head Neck Surg 2004; 131:525-7.4. Meyer TK, Kocak M, Smith MM, Smith TL. Coronal Computed Tomography Analysis of frontal cells. Am J Rhinol 2003;17(3):163-1685. Messerklinger W. Endoscopy of the nose. Baltimore: Urban and Schwaaenberg, 19786. Kayalioglu G, Oyar O, Govsa F. Nasal cavity and paranasal sinus bony variations: a computed tomographic study. Rhinology 2000;38:108-137. Bradley DT, Kountakis SE. The role of agger nasi air cells in patients requiring revision endoscopic frontal sinus surgery. Otolaryngol Head Neck Surg 2004; 131:525-7.8. Zhang L, Han D, Ge W, Xian J, Zhou B, Fan E, et al. Anatomical and computed tomographic analysis of the interaction between the uncinate process and the agger nasi cell. Acta Otolaryngol 2006;126:845-52.9. Gümüş C, Yıldırım A, Erdinç P, Öztoprak B, Karaman B, Frontal Hücre Varlığının Frontal Sinüzit ve Anatomik Varyasyonlar ile İlişkisi, C. Ü. Tıp Fakültesi Dergisi 2005;27(2): 69 – 7310. Küçükgünay B, Eskiizmir G, Ünlü H, Aslan A, Bayındır P, Ovalı GY, Özyur B, Normal popülasyonda ve frontal rinosinüzitli olgularda resessus frontalisin anatomik varyasyonlarının radyolojik olarak değerlendirilmesi, J Med Updates 2012;2(2):47-52 11. Eweiss AZ, Khalil HS. The prevalence of frontal cells and their relation to frontal sinusitis: a radiological study of the frontal recess area. ISRN Otolaryngol 2013; 2013: 687582.12. Azila A, Irfan M, Rohaizan Y, Shamim AK. The prevalence of anatomical variations in osteomeatal unit in patients with chronic rhinosinusitis. Med J Malaysia 2011; 66: 191-413. Kubota K, Takeno S, Hirakawa K. Frontal recess anatomy in Japanese subjects and its effect on the development of frontal sinusitis: computed tomography analysis. J Otolaryngol Head Neck Surg 2015; 44: 21.14. DelGaudio JM, Hudgins PA, Venkatraman G, Beningfield A. Multiplanar computed tomographic analysis of frontal recess cells. Arch Otolaryngol Head Neck Surg 2005; 131: 230-515. Yegin Y, Çelik M, Şimşek BM, Olgun B, Canpolat S, Kayhan FT, Agger Nasi Hücre Varlığı ile Frontal Sinüzit Arasındaki İlişki; Bilgisayarlı Tomografik Çalışma, Bezmialem Science 2017; 5: 112-5 16. Bayonne E, Kania R, Tran P, Huy B, Herman P. Intracranial complications of rhinosinusitis. A review, typical imaging data and algorithm of management. Rhinology 2009;47:59-65