Functional endoscopic sinus surgery(FESS) is now the surgical procedure of choice for treating chronic and recurrent sinusitis in patients of all ages. But successful eradication of disease from an obstructed frontal sinus ostium and frontal recess area is one of the most difficult procedures of FESS. It is known that the frontal sinus drainage is influenced by frontal cells, agger nasi cell, uncinate process attachment, concha cell, supraorbital cell and enlarged ethmoid bulla. We analyzed the coronal computed tomography of 118 frontal sinusitis cases and two control groups to compare which anatomic or mucosal factors can influence the developmemt of frontal sinusitis. In chronic sinusitis with frontal sinusitis group, frontal cell was observed in 11 cases(9.4%), agger nasi cell in 108 cases(91.5%), concha bullosa in 26 case(22.0%), supraorbital cell in 53 cases(44.9%), uncinate attachment to lamina papyracea in 76 cases(64.4%) and ethmoid bulla occupy 80.6% in the ostiomeatal area. In two control groups(chronic sinusitis without frontal sinusitis group and normal group) frontal cell was observed in 7 cases(10.5%) and 4 cases(6.0%), agger nasi cell in 54 cases(80.6%) and 43(65.2%), concha bullosa in 16 cases(23.9%) and 15 cases(22.8%), supra-orbital cell in 29 cases(43.3%) and 29 cases(43.9%), uncinate attachment to lamina papyracea in 55 cases(82.1%) and 53 cases(80.3%) and ethmoid bulla occupy 74.6% and 75.6% in ostiomeatal area. Our study concluded that the agger nasi cell, enlarged ethmoid bulla and attachment site of uncinate process can influence the development of frontal sinusitis(p<0.05).
Drainage ; Frontal Sinus* ; Frontal Sinusitis* ; Humans ; Sinusitis

Frontal sinusitis can cause an intractable frontal headache. Frequently, the external approach is performed for a lesion located in the lateral aspect of the frontal sinus. This area is considered to be "out of reach" for standard endoscopic instruments. However, problems such as scars can be a serious handicap of the external approach for patients with cosmetic concerns. We experienced a case of lateral frontal sinusitis associated with an intractable frontal headache, which was successfully treated via endoscopic sinus surgery aided by sagittal CT and intraoperative C-arm using K-wire instead of the external approach.
Cicatrix ; Cosmetics ; Frontal Sinus ; Frontal Sinusitis ; Headache ; Humans

Last spring, we experienced a case of frontal sinusitis with ocular deviation to lower lateral direction. This 49 year old male had complained of the ocular deviation with exophthalmos, visual disturbance and diplopia, since 5 months before. This case was recovered by external sinusotomy through superior nasal approach with remarkable results.
Diplopia ; Exophthalmos ; Frontal Sinus* ; Frontal Sinusitis* ; Humans ; Male ; Middle Aged

PURPOSE: To evaluate the dynamic patency of the frontonasal duct(FND) on PNS CT scan after administration ofan iso-osmolar contrast agent (lsovist) into the nasal cavity. MATERIALS AND METHODS: Coronal PNS CT scans from ten normal and 30 patients with symptoms of chronic sinusitis were obtained after administration of lsovist intothe nasal cavity, followed by Valsalva maneuver for the even distribution of the agent into the FND and sinuses. Atotal of 80 FNDs were evaluated for dynamic patency by examining the presence of the contrast agent in ducts. RESULTS: The contrast agent was visualized in 34/37 FNDs(91.9%) without ipsilateral frontal sinus it is and was visualized in 18/43 FNDs(41.9%) in cases of ipsilateral frontal sinusitis. In addition, the contrast agent within the ipsilateral frontal sinus was visualized in 8/18 FNDs(44.4%). The major causes of ductal obstruction were mucoperiosteal thickening and polypoid lesions secondary to inflammation. CONCLUSION: PNS CT scan together with the administration of lsovist, which caused minimal irritation, was useful for the evaluation of the relationship between the dynamic patency of the FND and frontal sinusitis, In addition, this study can provide the rhinologist with accurate anatomical and pathological information concerning the FND before a choice is made between endoscopic sinus surgery or medical treatment.
Frontal Sinus ; Frontal Sinusitis ; Humans ; Inflammation ; Nasal Cavity* ; Sinusitis ; Tomography, X-Ray Computed* ; Valsalva Maneuver

It is not common that formation of retrobulbar abscess by inflammatory spreading of chronic frontal sinusitis and even rare that the abscess cause acute exophthalmos and ocular pain. But, if the acute exophthalmos with ocular pain arise from the patient associated with chronic rhinitis or paranasal sinusitis, it should be suspected that peri bulbar abscess was formed by spreading of these disease and otorhinologic examination should be taken. The authors experienced a case of acute exophthalmos with ocular pain in a 27-years old woman and founded that abscess arising from the chronic frontal sinusitis disrupted the superomedial wall of orbit and spread to the retrobulbar area by computed tomography and other radiologic evaluation. We had good result by performing incision and drainage and some otorhinologic therapy.
Abscess ; Adult ; Drainage ; Exophthalmos* ; Female ; Frontal Sinus* ; Frontal Sinusitis* ; Humans ; Orbit ; Rhinitis ; Sinusitis

BACKGROUND AND OBJECTIVES: The frontal recess is the drainage pathway for the frontal sinus and its boundaries are formed by adjacent structures: they include agger nasi (anterior wall), medial orbital wall (lateral wall), ethmoid bulla/agger nasi (lateral wall), ground lamella (posterior wall), and anterior ethmoid air cells (posterosuperior). It is known that the drainage of the frontal recess is influenced by anatomic variants (agger nasi cell, frontal cells, supraorbital cell, intersinus septal cell, and attachment type of uncinate process). Because of its complex anatomy, the frontal sinus has been a difficult area in which to obtain consistently good long-term surgical results. SUBJECTIVES AND METHOD: To show the prevalence of anatomic variants and the relationship between the variants and frontal sinusitis, we analyzed the coronal and axial computed tomography of 225 patients, and 450 side sinuses (from 2001-6-1 to 2002-12-31). RESULTS: Frontal cells are observed in 176 cases (40.1%), agger nasi cell in 380 cases (84.8%), supraorbital cell in 17 cases (3.8%), and intersinus septal cell in 19 cases (11%). In the attachment type of the uncinate process, the lamellar type was seen in 272 cases (60.2%), the skull base type in 171 cases (26%), and the middle turbinate type in 62 cases (13.8%). The frontal sinusitis were seen in 8 cases (88.9%) among the type IV frontal cell group (9 cases) and in 149 cases (39.1%) among the agger nasi group. CONCLUSION: Relatively higher prevalence of anatomic variants was seen. The type IV frontal cells and agger nasi cells were significantly related to the frontal sinusitis.
Drainage ; Frontal Sinus* ; Frontal Sinusitis* ; Humans ; Orbit ; Prevalence ; Sinusitis ; Skull Base ; Turbinates

No abstract available.
Cluster Headache ; Frontal Sinus ; Frontal Sinusitis ; Headache ; Magnetic Resonance Imaging ; Sinusitis

PURPOSE: The purpose of the study is to investigate the correlation between the symptoms and the incidence of anatomical variant without mucosal abnormality. MATERIALS AND METHODS: Out of 892 patients with CT performed for the evaluation of sinus disease symptoms between March 1991 and March 1993, we observed the anatomic variations in 82 symptomatic patients without mucosal abnormality(male:female=43:39, mean age 36. 4 years). The control group included 88 patients with facial bone CT performed for the evaluation of trauma during the same period while patients with recent paranasal sinusitis were excluded. (male:female=76:12, mean age 22. 4 years). The scouis were performed with 5-ram section thickness from posterior margin of sphenoid sinus to anterior margin of posterior ethmoid and then with 3 mm thickness from anterior margin of posterior ethmoid to anterior margin of frontal sinus. The artatomic variations included nasoseptal deviation, concha bullosa, Hailer cells, Agger nasi cells, etc. RESULTS: The anatomic variations were demonstrated in 71 our of 82 symptomatic patients(86. 5%), whereas they were seen 26 of 88 patients(29. 5%) in control group. CONCLUSION: Our data suggest that there is a possible causal relationship between anatomic variations and symptomas. Even though without accompaning mucosal abnormalities, anatomic variations could contribute simply to its symptomas. ^natomic variants may obstruct or narrow the airway, leading to turbulating air flow or interrupting ucociliary movement, and finally may produce a series os symptoms.
Facial Bones ; Frontal Sinus ; Humans ; Incidence ; Sinusitis ; Sphenoid Sinus

The author reports a patient with a frontal sinus osteoma causing pansinusitis, epidural abscess and brain abscess. For while this tumor is benign its complications are serious. So the author recommends that these tumors should be removed while small, before producing serious symptoms.
Brain Abscess* ; Brain* ; Epidural Abscess ; Frontal Sinus* ; Humans ; Osteoma* ; Sinusitis

BACKGROUND AND OBJECTIVES: The anterior ethmoid canal is the important surgical landmark in endoscopic sinus surgery, intranasal ethmoidectomy, and frontal sinus surgery. However it is not enough to evaluate the anterior ethmoid canal by coronal OMU CT, especially relating anterior to posterior relationship of the anterior ethmoid canal. The pulpose of this study is to evaluate the anterior ethmoid canal in 1 mm axial OMU CT and measure the five parameters relating the anterior ethmoid canal. MATERIALS AND METHODS: A prospective study was performed in 100 sinuses of 50 patients with chronic sinusitis who underwent endoscopic sinus surgery from May through July of 1998. RESULTS: The anterior ethmoid canal is well demonstrated by 1 mm axial OMU CT. The average of five parameters are 6.2+/-1.5 mm, 6.4+/-4.3 mm, 18.5+/-3.9 mm, 26.5+/-5.6 mm, 24.6+/-14.6degrees. However, there is no difference between the right and left side statistically. We observed that the anterior ethmoid canal is located just posterior to the frontal recess without anterior ethmoid air cell in front of the antirior ethmoid canal in 23%. CONCLUSION: The anterior ethmoid canal is well remarked by the 1 mm axial OMU CT. The length and directional angle of the anterior ethmoid canal is individually variable and there is no anterior ethmoid air cell in front of the anterior ethmoid canal in 23%. In these cases, the anterior ethmoid canal is more likely to be injured. So axial OMU CT may be useful in the radiologic evaluation for endoscopic sinus surgery in chronic sinusitis.
Frontal Sinus ; Humans ; Nasal Surgical Procedures ; Prospective Studies ; Sinusitis