A prospective study of the prevalence of Kuhn’s frontal cells and their relation to frontal sinus disease
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20193864Keywords:
Frontal sinus, Kuhn cells, Computerised tomography, Chronic-sinusitisAbstract
Background: The involvement of frontal cells in the frontal sinus disease pathology remains an understudied area. There are very few reports on the prevalence of frontal recess cells in India. In this context the present study was designed to determine the frequency of occurrence of Kuhn frontal cells and to determine whether the size of the frontal isthmus or the presence of frontal cells is related to the presence of frontal sinus disease.
Methods: This study included 80 patients who presented with signs and symptoms of chronic rhino-sinusitis after satisfying the inclusion criteria to the Department of ENT in a tertiary care centre (Mahatma Gandhi Medical College and Research Institute) in Pondicherry from January 2017 to April 2018. The patients were subjected to detailed clinical history, basic preoperative blood investigations, diagnostic nasal endoscopy and High Resolution Computed Tomography of nose and para-nasal sinuses after which the diagnosis was established.
Results: Out of the 80 study participants subjected to our study the number of individuals who had frontal sinusitis was 50%. The association between frontal sinusitis and Kuhn cells was insignificant. The mean value of anteroposterior diameter of the naso-frontal isthmus in case of patients with and without frontal sinusitis was 0.705-0.735. In case of transverse diameter it was 0.725-0.720 and in case of the area of the frontal isthmus it was 30.86-31.12 which had a p value of 0.49
Conclusions: Therefore in our study we concluded that there is no significant relation for any particular frontal recess cell or the size of the nasofrontal isthmus for being the sole cause for chronic frontal sinusitis.
References
DelGaudio JM, Hudgins PA, Venkatraman G, Beningfield A. Multiplanar computed tomographic analysis of frontal recess cells: effect on frontal isthmus size and frontal sinusitis. JAMA Otolaryngol-Head and Neck Surg. 2005;131(3):230-5.
Van Alyea OE. Frontal cells: an anatomic study of these cells with consideration of their clinical significance. Arch Otolaryngol. 1941;34(1):11-23.
Stankiewicz JA. Advanced endoscopic sinus surgery. CV Mosby; 1995. Otolaryngol Head Neck Surg. 2003;131:164
Stammberger H, Posawetz W. Functional endoscopic sinus surgery. Europ Arch Oto-Rhino-Laryngol. 1990;247(2):63-76.
Wormald PJ. The agger nasi cell: the key to understanding the anatomy of the frontal recess. Otolaryngol Head Neck Surg. 2003;129(5):497-507.
Bent JP, Cuilty-Siller C, Kuhn FA. The frontal cell as a cause of frontal sinus obstruction. Am J Rhinol. 1994;8(4):185-92.
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.
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(4):525-7.
Bolger WE, Parsons DS, Butzin CA. Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. Laryngoscope. 1991;101(1):56-64.
Som PM, Lawson W. Interfrontal sinus septal cell: a cause of obstructing inflammation and mucoceles. Am J Neuroradiol. 2008;29(7):1369-71.
Han D, Zhang L, Ge W, Tao J, Xian J, Zhou B. Multiplanar computed tomographic analysis of the frontal recess region in Chinese subjects without frontal sinus disease symptoms. ORL J Otorhinolaryngol Relat Spec. 2008;70(2):104-12.
Lien CF, Weng HH, Chang YC, Lin YC, Wang WH. Computed tomographic analysis of frontal recess anatomy and its effect on the development of frontal sinusitis. Laryngoscope. 2010;120(12):2521-7.
Han D, Zhang L, Ge W, Tao J, Xian J, Zhou B. Multiplanar computed tomographic analysis of the frontal recess region in Chinese subjects without frontal sinus disease symptoms. ORL J Otorhinolaryngol Relat Spec. 2008;70(2):104-12.
Turgut S, Ercan I, Sayın I, Başak M. The relationship between frontal sinusitis and localization of the frontal sinus outflow tract: a computer-assisted anatomical and clinical study. Arch Otolaryngol Head and Neck Surg. 2005;131(6):518-22.
Kuhn FA. Chronic frontal sinusitis: the endoscopic frontal recess approach. Operative Techniques in Otolaryngol Head and Neck Surg. 1996;7(3):222-9.
Meyer TK, Kocak M, Smith MM, Smith TL. Coronal computed tomography analysis of frontal cells. Am J Rhinol. 2003;17(3):163-8.
Kew J, Rees GL, Close D, Sdralis T, Sebben RA, Wormald PJ. Multiplanar reconstructed computed tomography images improves depiction and understanding of the anatomy of the frontal sinus and recess. Am J Rhinol. 2002;16(2):119-23.
Lee WT, Kuhn FA, Citardi MJ. 3D computed tomographic analysis of frontal recess anatomy in patients without frontal sinusitis. Otolaryngol Head Neck Surgery. 2004;131(3):164-73.
Landsberg R, Friedman M. A computer‐assisted anatomical study of the nasofrontal region. Laryngoscope. 2001;111(12):2125-30.
Sagar GR, Jha BC, Meghanadh KR. A study of anatomy of frontal recess in patients suffering from ‘chronic frontal sinus disease’. Indian J Otolaryngol Head Neck Surg. 2013;65(2):435-9.
