Garret Choby1,2, Andrew Thamboo1,3, Tae-Bin Won4, Jooyeon Kim5, Liang Chun Shih6, Peter H Hwang1. 1. Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, CA. 2. Department of Otorhinolaryngology-Head & Neck Surgery, Mayo Clinic, Rochester, MN. 3. Department of Otolaryngology-Head & Neck Surgery, University of British Columbia School of Medicine, Vancouver, BC, Canada. 4. Department of Otolaryngology-Head & Neck Surgery, Seoul National University Hospital, Seoul, Korea. 5. Department of Otolaryngology-Head & Neck Surgery, Kosin University College of Medicine, Busan, Republic of Korea. 6. Department of Otolaryngology-Head & Neck Surgery, China Medical University Hospital, Taichung, Taiwan, ROC.
Abstract
BACKGROUND: The International Frontal Sinus Anatomy Classification (IFAC) is an international consensus document published in 2016 to standardize the nomenclature of cells in the region of the frontal recess and frontal sinus. The IFAC was designed to be surgically relevant and anatomically precise. The current study was undertaken to assess the prevalence of the frontal cell variants as defined by the IFAC, as well as to determine the interrater reliability of the IFAC. METHODS: Three independent reviewers examined triplanar nondiseased maxillofacial computed tomography (CT) scans to assess the anatomy of the frontal recess according to the IFAC system. The prevalence of each cell type was assessed and interrater reliability was measured using an intraclass correlation coefficient (ICC). RESULTS: One hundred CT scans (200 sides) were examined. Of the 200 sides, 96.5% contained an agger nasi cell (ICC, 0.82; 95% confidence interval [CI], 0.77-0.86), 30.0% contained a supra agger cell (ICC, 0.89; 95% CI, 0.86-0.92), 20.0% contained a supra agger frontal cell (ICC 0.80; 95% CI 0.74-0.84), 72.0% contained a supra bulla cell (ICC, 0.81; 95% CI, 0.76-0.85), 5.5% contained a supra bulla frontal cell (ICC, 0.71; 95% CI, 0.63-0.77), 28.5% contained a supraorbital ethmoid cell (ICC, 0.78; 95% CI, 0.72-0.83), and 30.0% contained a frontal septal cell (ICC, 0.80; 95% CI, 0.74-0.84). The ICC was good to excellent for identification of all frontal cell types. CONCLUSIONS: This study describes the normative distribution of frontal recess cells in a nondiseased population according to IFAC and demonstrates favorable interrater reliability of the classification system.
BACKGROUND: The International Frontal Sinus Anatomy Classification (IFAC) is an international consensus document published in 2016 to standardize the nomenclature of cells in the region of the frontal recess and frontal sinus. The IFAC was designed to be surgically relevant and anatomically precise. The current study was undertaken to assess the prevalence of the frontal cell variants as defined by the IFAC, as well as to determine the interrater reliability of the IFAC. METHODS: Three independent reviewers examined triplanar nondiseased maxillofacial computed tomography (CT) scans to assess the anatomy of the frontal recess according to the IFAC system. The prevalence of each cell type was assessed and interrater reliability was measured using an intraclass correlation coefficient (ICC). RESULTS: One hundred CT scans (200 sides) were examined. Of the 200 sides, 96.5% contained an agger nasi cell (ICC, 0.82; 95% confidence interval [CI], 0.77-0.86), 30.0% contained a supra agger cell (ICC, 0.89; 95% CI, 0.86-0.92), 20.0% contained a supra agger frontal cell (ICC 0.80; 95% CI 0.74-0.84), 72.0% contained a supra bulla cell (ICC, 0.81; 95% CI, 0.76-0.85), 5.5% contained a supra bulla frontal cell (ICC, 0.71; 95% CI, 0.63-0.77), 28.5% contained a supraorbital ethmoid cell (ICC, 0.78; 95% CI, 0.72-0.83), and 30.0% contained a frontal septal cell (ICC, 0.80; 95% CI, 0.74-0.84). The ICC was good to excellent for identification of all frontal cell types. CONCLUSIONS: This study describes the normative distribution of frontal recess cells in a nondiseased population according to IFAC and demonstrates favorable interrater reliability of the classification system.
Authors: Noor Elyana Ahmad Fawzi; Norhafiza Mat Lazim; Mohd Ezane Aziz; Zahiruddin Wan Mohammad; Baharudin Abdullah Journal: Eur Arch Otorhinolaryngol Date: 2021-04-29 Impact factor: 2.503
Authors: Jan Cvrček; Rebeka Rmoutilová; Markéta Čechová; Tomáš Jor; Jana Velemínská; Jaroslav Brůžek; Ondřej Naňka; Petr Velemínský Journal: J Anat Date: 2020-06-02 Impact factor: 2.921