Relationship Between Anatomical Variations in the Frontal Recess Area and the Incidence Rate of Frontal Rhinosinusitis

Abstract

Introduction: The most prevalent cause of rhinosinusitis is abnormalities in the nose and paranasal sinuses. Obstacles to frontal sinus flow can arise due to variations in the anatomy of the frontal sinus, where the drainage system is linked to the frontal recess.

Objectives: Determine the relationship between anatomical variations in the frontal recess and the incidence rate of chronic rhinosinusitis..

Methods: A cross-sectional study was conducted between March and September 2023 at Central General Hospital Dr. Wahidin Sudirohusodo and Hasanuddin Faculty Teaching Hospitals in Makassar, including patients with chronic rhinosinusitis (CRS) symptoms who underwent paranasal sinus CT scans and met the inclusion criteria. Patients were categorized into CRS with and without frontal sinus involvement. An assessment of anatomical variations in the frontal recess area was conducted in each group, and their relationship with the incidence rate of frontal rhinosinusitis was analyzed using the SPSS application.

Results: The supra agger nasi anatomical variant showed a significant association with the incidence of right frontal rhinosinusitis (p=0.042). On the left side, supra agger and supra bulla cells were associated with the incidence of rhinosinusitis involving anterior ethmoid sinusitis (p=0.006 and 0.015, respectively), as well as posterior ethmoid sinusitis (p=0.027 and 0.042, respectively). There was no significant relationship found between variations in the anterosuperior uncinate process attachment and the incidence of right (p=0.990) or left frontal rhinosinusitis (p=0.999). The type of drainage did not exhibit a statistically significant association with the incidence of left and right frontal rhinosinusitis (p>0.05).

Conclusions: The frequency of frontal rhinosinusitis is significantly correlated with anatomical abnormalities in the anterior frontal recess area (supra agger nasi).