Nasofrontal Complex Variation Frontal Sinus Drainage System Increases Frontal Rhinosinusitis Incident

Abdul Qadar Punagi


BACKGROUND: This research was conducted to find out the relation of anatomy variation of nasofrontal complex on the frontal sinus drainage system with frontal rhinosinusitis incident. 

METHODS: This research was using cross-sectional design involving 75 patients with chronic rhinosinusitis. Coronal paranasal sinus CT scan with sagittal plane reformat was carried out to examine. The CT scan figures were analyzed from every side and there were 150 samples found as the result. Data was analyzed using chi square test. 

RESULTS: The research indicates that there is no significant relation between frontal cell types, agger nasi cell, chonca media bullosa with incident of frontal rhinosinusitis (p>0.05). Prevalence of superior attachment of uncinate process (UP), type 1 (UP superior attachment on lamina papiracea) was found on 43 sides (28.6%), type 6 (UP superior attachment to medial turbinate) was found in 29 sides (19.3%). Prevalence of frontal rhinosinusitis was found in 42 (28%) from 150 sides. Group 1 drainage (medial side drainage; drainage to meatus medius [type 1-3]) was found in 32 sides (76.2%) and group 2 drainage (lateral side drainage; drainage to infundibulum ethmoid [type 4-6]) was found in 10 sides (23.8%). 

CONCLUSION: There is significant relation between frontal rhinosinusitis incident with variation of frontal sinus drainage (p<0.05) and drainage on group 1 has significant existence statistically on frontal rhinosinusitis incident. 

KEYWORDS: frontal rhinosinusitis, anatomy variation, nasofrontal complex, frontal sinus drainage 

Full Text:



Turgut S, Ercan I, Sayin I, Basak M. The relationship between frontal sinusitis and localization of the frontal sinus outflow tract: a computer-assisted anatomical and clinical study. Arch Otolaryngol Head Neck Surg. 2005; 131: 518-22, CrossRef.

McLaughlin RB Jr, Rehl RM, Lanza DC. Clinically relevant frontal sinus anatomy and physiology. Otolaryngol Clin North Am. 2001; 34: 1-22, CrossRef.

Kennedy DW, Bolger WE. The paranasal sinuses: embriology, anatomy, endoscopic diagnosis, and treatment. In: Lee KJ, editors. Essential otolaringology head and neck surgery. 8th ed. New York: McGraw-Hill; 2003. p.388-410, NLMID.

DelGaudio JM, Hudgins PA, Venkatraman G, Beningfield A. Multiplanar computed tomographic analysis of frontal recess cells: effect on frontal isthmus size and frontal sinusitis. Arch Otolaryngol Head Neck Surg. 2005; 131: 230-5, CrossRef.

Figueroa RE, Sullivan J. Radiologic anatomy of the frontal sinus. In: Kountakis S, Senior B, Draft W, editors. The frontal sinus. Berlin: Springer; 2005, p.7-20, CrossRef.

Seiden AM, Stankiewicz JA. Frontal sinus surgery: The state of the art. Am J Otolaryngol. 1998; 19: 183-93, CrossRef.

Meyer TK, Kocak M, Smith MM, Smith TL. Coronal computed tomography analysis of frontal cells. Am J Rhinol. 2003; 17: 163-8, PMID.

Rante F, Murtala B, Punagi Q. Relationship anatomical variations according kuhn frontal cells and agger nasi cells on CT scans of the sinuses paranasalis with frontal rhinosinusitis events [Thesis]. Makassar: University of Hasanuddin; 2011.

Bent JP, Cuilty-Siller C, Kuhn FA. The frontal cell as a cause of frontal sinus obstruction. Am J Rhinology. 1994; 8: 185-91, CrossRef.

Landsberg R, Friedman M. A computer-assisted anatomical study of the nasofrontal region. Laryngoscope. 2001; 111: 2125-30, CrossRef.

Kim KS, Kim HU, Chung IH, Lee JG, Park IY, Yoon JH. Surgical anatomy of the nasofrontal duct: anatomical and computed tomographic analysis. Laryngoscope. 2001; 111: 603-8, CrossRef.

Gaffar H, Abdel-Monem MH, Qavas MK. Frontal sinus outflow tract anatomic study. Acta Otolaryngol. 2001; 121: 305-9, CrossRef.

Lee D, Brody R, Har-El G. Outflow frontal sinus anatomy. Am J Rhinol. 1997; 11: 283-5, CrossRef.


Indexed by:






The Prodia Education and Research Institute