The paranasal sinuses in CT-imaging: development from birth to age 25.

Available data about the size of the different sinuses to date are derived from anatomical or radiological studies. In order to verify or possibly correct the findings of other authors we evaluated the cranial computed tomography (CT)-images of more than 5600 patients. We measured the sex-linked and age-dependent width and length of the four sinuses for both sides in axial sections. For the first time we have a clear picture of the development of the paranasal sinuses for both sexes from birth until the age of 25 years. Our results confirm general ideas concerning the size of the sinuses. Moreover they provide new details, especially about the first occurrence and the course of development in different stages since we found each sinus already present in 1.5% (frontal sinus) to 94% (ethmoid cells) of the newborn of both sexes. Finally, we can state that the periods of expansion are equal in both sexes (ethmoid cells) or last up to 2 or 3 years longer (frontal sinus) in male patients. In agreement the sinuses of both sexes differ between 5.4% (sphenoid sinus) and 17.1% (frontal sinus) in definitive size with statistically significant differences in later ages. The data about sphenoid sinuses deserve special attention since they show a large variability in size (up to 214% in one direction) as well as in shape.