What question did this study set out to answer?

To study the prevalence of frontal recess cells and evaluate the interrater agreement of the International Frontal Sinus Anatomy Classification.

March 1, 2026

Computed Tomographic Analysis of Frontal Recess Cell Prevalence According to International Frontal Sinus Anatomy Classification

Key Points

To study the prevalence of frontal recess cells and evaluate the interrater agreement of the International Frontal Sinus Anatomy Classification.
Retrospective analysis of 509 adults with non-diseased paranasal sinuses using CT scans.
Two researchers identified frontal recess cells on 1018 sides with triplanar CT reconstructions.
Prevalence of each cell type was assessed, and interobserver agreement was evaluated with the Kappa coefficient.
Agger nasi cell (ANC) had the highest prevalence of 88.0%, while supra bulla cell (43.0%) was second.
Bilateral incidence for ANC was 80.4%; lowest for supra bulla frontal cell (2.2%).
Gender differences noted in supra agger cell and supra agger frontal cell prevalence, with males having higher rates of some cells.
FR cells pneumatizing into the frontal sinus were seen in 28.6% of cases, more prevalent in males.
Excellent interrater agreement was observed (κ values from 0.94 to 1.0).

Abstract

Objective: To examine the prevalence of frontal recess (FR) cellsbased on the International Frontal Sinus Anatomy Classification(IFAC) in healthy sinuses, as well as evaluate the interrateragreement of the IFAC system.Methods: Five hundred nine adult patients with non-diseasedparanasal sinuses on computed tomography (CT) wereretrospectively included in this study. Two researchersindependently identified FR cells on 1018 sides using triplanar CTreconstructions. The prevalence of each cell type was assessed,and interobserver agreement was measured using the Kappacoefficient (κ).Results: In our population, the agger nasi cell (ANC) had thehighest prevalence (88.0%), followed by supra bulla cell (43.0%),supra agger cell (SAC) (25.0%), frontal septal cell (22.0%),supraorbital ethmoid cell (17.1%), supra agger frontal cell (SAFC)(8.3%), and supra bulla frontal cell (SBFC) (7.1%). Bilateralincidence was highest for the ANC (80.4%) and lowest for theSBFC (2.2%). The prevalence of most IFAC cells was similarbetween males and females, except in SAC (27.8% in females vs.22.2% in males) and SAFC (11.6% in males vs. 5.1% in females).FR cells that pneumatize into the frontal sinus were observed in28.6% of cases, with a significantly higher prevalence in malepatients compared to females. Excellent interrater agreementwas found for all FR cells, with κ values ranging from 0.94 to 1.0.Conclusion: The prevalence of FR cells demonstrates variationsspecific to the population. Gender differences appear toinfluence the presence of cells pneumatizing into the frontalsinus. The IFAC is a reliable tool for identifying cells in the FR.Keywords: International frontal sinus anatomy classification,sinus anatomy, frontal cells, computed tomograpy

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Cite This Study

YAYLACI et al. (Sat,) studied this question.

synapsesocial.com/papers/69a3d8caec16d51705d2fee5 https://doi.org/https://doi.org/10.53446/actamednicomedia.1443046

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