Absence of frontal sinus in Turkish individuals

The frontal sinus has been used for personal identification since the early part of the 20th century as a result of its tremendous interindividual variation. The frontal sinus is present in approximately 90% of adults. However, some populations have a higher proportion of people without a frontal sinus. This study investigated the frequency of the absence of frontal sinuses in Turkish individuals. The present study was performed retrospectively on the CT scans of the paranasal sinuses in the axial and coronal planes from a series of 1200 cases. A bilateral absence and a unilateral absence of sinuses were found in 3.8% and 4.8% of cases, respectively. The clinical significance of the frontal sinuses and their absence are also discussed.     

Aplasia and agenesis of the frontal sinus in Turkish individuals: a retrospective study using dental volumetric tomography

Agenesis of the paranasal sinuses is an uncommon clinical condition that appears mainly in the frontal (12%) and maxillary (5-6%) sinuses; in some populations, it appears at a higher proportion. This study investigated the prevalence of agenesis of the frontal sinuses using dental volumetric tomography (DVT) in Turkish individuals. The frontal sinuses of 410 patients were examined by DVT scans in the coronal planes for evidence of the absence of the frontal sinuses. A bilateral and unilateral absence of the frontal sinuses was seen in 0.73% and 1.22% of cases, respectively. In one case, both agenesis and aplasia of the frontal sinus was seen (0.24%). The low percentage of frontal sinus agenesis must be considered during pre-surgical planning related to the sinuses. DVT may be used as a diagnostic tool for the examination of frontal sinus aplasia.     

Comparison between transillumination and the roentgenogram in diagnosing paranasal sinus disease

The reliability of transillumination versus roentgenogram to diagnose maxillary and frontal paranasal sinus disease was assessed in 52 subjects with rhinitis and/or asthma. Two different otolaryngologists transilluminated the sinuses while the roentgenograms were evaluated by a radiologist and a third otolaryngologist. Patients filled in questionnaires of symptoms. There was excellent agreement (p < 0.001) between otolaryngologists regarding transillumination of the frontal sinuses but not the maxillary sinuses. Similarly, transillumination of the frontal sinuses correlated well with the roentgenograms. This was not true for transillumination of the maxillary sinuses. Although pain in the upper teeth related well to the presence of frontal disease, sinus headache was a frequent complaint but not useful as a predictor of sinus disease. Even though transillumination of the frontal paranasal sinus has some predictive value, the technique of transillumination has limited usefulness as a diagnostic tool and is not an adequate substitute for roentgenogram.     

小儿额窦的年龄解剖学观测

作者解剖观测了180具(男97、女83)新生儿、身长51～70、71～90、91～110、111～150cm六组(每组30例)小儿尸的额窦:1.新生儿额窦均未发育;Ⅱ组(51cm～)大部分不发育;在Ⅲ组(71cm～)中左右分别有3例(10%)不发育。2.额窦半数以上开口于额隐窝,左侧占51.72%,右侧占54.02%;余者开口于筛漏斗。3.额窦的形态以椭圆形占大多数,其余尚有圆形、哑铃形、舟形和三角形。4.测得了各组额窦的上下、前后、左右径及其容积。     

Frontal sinus anatomical variations with potential consequences for the orbit. Study on cadavers

Anatomical variations of the frontal sinuses that may play a role in the correlation between frontal sinusitis and orbital complications are described. There were used 18 cadavers during routine educational cadaver dissections, one month after theirs withdrawal from the formol basin. The dissections of the cranial cavity and the orbits were performed so as to reveal the frontal sinuses. An unusual bilateral posterior extension of the frontal sinus mucosa was found in two of the cadavers. The projection of the mucosa was covering half of the orbital roof in a 60 year old male and one third of the orbital roof in a 59 year old male. Among the other cadavers that presented normal variations of the frontal sinuses, there was also a case of a 57 year old female with a complete aplasia of the frontal sinuses. Such anatomical variations with unusual extension of the frontal sinuses above orbital roof may support the correlation between frontal sinusitis and the possible complications from the orbit and these cases may be considered as 'high risk' cases for orbital complications during a frontal sinusitis.     

Gas monitoring in human sinuses using tunable diode laser spectroscopy

We demonstrate a novel nonintrusive technique based on tunable diode laser absorption spectroscopy to investigate human sinuses in vivo. The technique relies on the fact that free gases have spectral imprints that are about 10.000 times sharper than spectral structures of the surrounding tissue. Two gases are detected; molecular oxygen at 760 nm and water vapor at 935 nm. Light is launched fiber optically into the tissue in close proximity to the particular maxillary sinus under study. When investigating the frontal sinuses, the fiber is positioned onto the caudal part of the frontal bone. Multiply scattered light in both cases is detected externally by a handheld probe. Molecular oxygen is detected in the maxillary sinuses on 11 volunteers, of which one had constantly recurring sinus problems. Significant oxygen absorption imprint differences can be observed between different volunteers and also left-right asymmetries. Water vapor can also be detected, and by normalizing the oxygen signal on the water vapor signal, the sinus oxygen concentration can be assessed. Gas exchange between the sinuses and the nasal cavity is also successfully demonstrated by flushing nitrogen through the nostril. Advantages over current ventilation assessment methods using ionizing radiation are pointed out.     

Extension of the frontal sinus into the roof of the optic canal: a cadaveric case report

This case reports a bilateral asymmetrical posterior extension of the frontal sinuses into the orbital roof with an unusual expansion into the roof of the optic canal in a 55-year-old male cadaver. The posterior extensions of the sinus were lined by mucoperiosteum and were separated from the underlying orbital contents and optic nerve by a thin plate of bone. This knowledge of an unusual anatomic variation of the frontal sinus may help understand better the ocular and intracranial complications associated with frontal sinus pathologies.     

Radiologic anatomy of the paranasal sinuses in the child

Summary The development of the paranasal or accessory sinuses begins very early in utero. In the newborn the ethmoidal sinus, which gives rise to all the other sinuses, as well as the maxillary sinus, can already be identified on x-rays. The frontal sinus appears as a triangle at the age of four and oversteps the supraorbital margin at the age of six. The sphenoidal sinus begins to excavate the concha sphenoidalis at the age of four and can be seen on x-rays at the age of eight, when it extends to the hypophyseal fossa. In the twelve-year-old child all sinuses almost reach their final sizes. However, the size and shape of all sinuses, particularly of the frontal and the sphenoidal sinuses are very different.

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Anatomie radiologique des sinus para-nasaux chez l'enfant

Résumé Le développement des sinus para-nasaux ou sinus accessoires commence très précocement dans la vie in-utéro. Chez le nouveau-né le sinus ethmoïdal, qui contrôle l'apparition de tous les autres sinus, et le sinus maxillaire peuvent déjà être identifiés à la radio. Le sinus frontal a la forme d'un triangle a l'âge de 4 ans et franchit la ligne supra-orbitaire à 6 ans. Le sinus sphénoïdal commence à creuser le cornet sphénoïdal dès l'âge de 4 ans et devient visible à la radio à 8 ans lorsqu'il s'étend jusqu'à la fosse hypophysaire. Chez l'enfant de 12 ans tous les sinus ont pratiquement atteint leur taille adulte. Cependant la taille et la forme de ces sinus et spécialement les sinus frontaux et sphénoïdaux sont très différentes.

     

In vivo model for frontal sinus and calvarial bone defect obliteration with bioactive glass S53P4 and hydroxyapatite

An in vivo model was developed to investigate the usability of a frontal sinus and a calvarial bone defect obliteration with bioactive glass S53P4 (BG) and hydroxyapatite (HA) granules. Roofs of 21 Elco rabbit frontal sinuses were drilled open from 4 separate holes using a standard method, and the sinuses, located in pairs, in frontal bone were filled with BG on one side and with HA on the other side. Two parallel posterior defects were covered with a pedicled periosteum flap, and 2 anterior defects with a free flap. The stability of materials, new bone, and connective tissue formation were observed with histomorphometry, scanning electron microscopy (SEM), energy dispersive X-ray analysis (EDXA), and X-ray pictures at 1, 3, 6, and 12 months postoperatively. The results showed more rapid resorption of filling material (p = 0.019) and new bone formation (p = 0.0001) in the defects filled with BG than in the corresponding HA-filled defects studied by histomorphometry throughout the study. New bone formation and resorption of materials were faster in defects covered by a pedicled flap than by a free periosteum flap. The results were supported by SEM histomorphometric and radiologic analysis. Both bioactive materials studied were well tolerated in frontal sinuses and in calvarial bone defects. The experimental model showed the influence of early periosteum vascularization on accurate frontal sinus filling and the healing process in rabbit frontal sinuses.     

Morphometric evaluation of the frontal sinus in relation to age.

To investigate the development of the frontal sinus size during life, we studied the planar morphometry in 60 frontal radiographs of patients of different age and gender. A professional software (Bersoft Image 4.02) was used to measure the frontal area of the right and left frontal sinuses on radiographic images. A frontal sinus was already evident in 4-year-old children. Unilateral or bilateral absence of the frontal sinus was seen in 5% of cases. The size of the sinusal area increases up to 19-year-old patients, synchronous with general craniofacial growth. In adults, individual differences in size and shape occurred in relation to environmental factors. In some elderly patients, osseous resorption led to an enlargement of the frontal sinus that might complicate surgical procedures performed in this area.     

鼻旁窦的年龄断面解剖学研究

目的：为影像学诊断和鼻旁窦手术的最佳年龄提供解剖学依据。方法：采用三组年龄的国人头部标本２９例，各组标本均按等比例分别切割为横切面、矢状切面和冠状切面。结果：各组标本均可见明显的上颌窦和筛窦；幼儿组未见显著的额窦和蝶窦。学龄组５０％未见明显的额窦和筛窦，余组标本可见额窦和蝶窦。成人上颌窦开口的长轴呈水平状，儿童上颌窦开口为向外下方的斜形管道。结论：鼻旁窦的形态有明显的年龄变化，窦额窦和蝶窦的最初气     

Biological relationships and frontal sinus similarity in skeletal remains with known genealogical data

Frontal sinus analysis has potential utility for detecting biologically related individuals. However, the methodological approach to its evaluation, as well as its informative value, have been questioned. The aim of this work is to introduce a new approach to evaluating the frontal sinus using the ‘external supraorbital line’ (ESOL) and to determine whether there are sex differences within families in frontal sinus measurements and whether frontal sinus similarity reflects known genetic relationships in both measurements and morphology. We examined the skeletal remains of 41 adult individuals (25 males, 16 females), all members of one family over four generations (19th to 20th centuries), including individuals with very close consanguinity. CT images of skulls were acquired, and both the dimensions and morphology of the frontal sinuses were analyzed using their portions above the ESOL. No significant sex differences were found within families based on frontal sinus dimensions. Significant relationships were found between biological distance and the maximum height and morphology of the frontal sinuses. The greatest degree of similarity was found among closely related individuals. Additionally, in several cases, there was a greater degree of similarity between first cousins or grandparents and their grandchildren than among siblings or parents and their children. Total surface, volume and width are not significant indicators of relatedness. Known genetic relationships are also supported by individual morphological features. Variability within families with very close consanguineous relationships was lower than within families with common degrees of consanguinity, although differences are significant only for some variables.     

Functional endoscopic sinus surgery--I (Anatomy, diagnosis, evaluation and technique)

It has been proved beyond doubt that the causation and perpetuation of disease in the dependent sinuses (maxillary and frontal sinuses) is secondary to disease of the ostiomeatal complex, the primary focus of which is the anterior ethmoid. Based on this concept, functional endoscopic sinus surgery (FESS) aims at correcting the underlying pathology in the ethmoids and helps to re-establish normal ventilation and mucociliary clearance of the dependent sinuses.     

Sinusitis in Thai asthmatic children.

The radiographic appearance of sinuses was studied in 146 Thai asthmatic patients aged 1-13 years. Forty-eight percent of cases showed sinusitis by the radiographic criteria. The maxillary sinus was most commonly involved (98.6%). Thirty-three percent had ethmoidal sinusitis and 7% of those with developed frontal sinuses had frontal sinusitis. Thirty-three percent had more than one sinus involved. Those with frontal sinusitis always had maxillary and/or ethmoidal involvement. Sixteen cases had signs and symptoms of sinusitis and all of the cases had the radiographic appearance of sinusitis. There was no correlation between the occurrence of sinusitis and duration or severity of asthma. There was no difference in the occurrence of sinusitis between those with or without allergic rhinitis. No correlation between severity of sinusitis and age of patients was observed.     

Frontal sinus anatomy of the noble Swéerts-Sporck family and verification of their biological relationships using similarity analysis

The evaluation of frontal sinus similarity is one way to detect biological relationships, especially in small groups, including families of historically known personalities. However, possibilities for studying this issue are currently limited. This contribution deals with the frontal sinuses of a rare osteological sample with known genealogical data, members of the noble Swéerts-Sporck family from the 17th to 20th centuries. The aim is to verify whether the frontal sinuses reflect documented family relationships. Basic dimensions of the frontal sinus such as total surface area and volume, and maximum height and width, and also morphology and anatomical features were evaluated using computed tomography scans. The portions of the frontal sinus above the “external supraorbital line” were analyzed. The degree of similarity between biologically related individuals was determined for each variable and compared with their known biological distance. The degree of similarity based on dimensions was evaluated using both the unadjusted measured data and standardized data adjusted to size. For the unadjusted dimensions, a positive correlation between morphological similarity and biological relatedness was apparent. On the other hand, no positive correlation was apparent for most of the standardized data. Only total volume showed a very weak indication of a positive trend in the standardized data, but this was weaker than in the original values. A positive quantifiable relationship between morphological patterns and biological distance is not clearly indicated. However, nonmetric features do support the documented relationships of the individuals.     

Computed tomography measurements of different dimensions of maxillary and frontal sinuses

Background  

We have previously proposed the use of Doppler ultrasound to non-invasively stage sinus infection, as we showed that acoustic streaming could be generated in nonpurulent sinus secretions and helped to distinguish it from mucopurulent sinus secretions. In order to continue this development of a clinically applicable Doppler equipment, we need to determine different dimensions of the paranasal sinuses, especially the thickness of the anterior wall of the maxillary sinus (at the canine fossa). To the best of our knowledge, this is the first report on the thickness of the canine fossa. This study aimed to (a) estimate different dimensions of the maxillary and frontal sinuses measured on computed tomography (CT) of the head, (b) define cut-off values for the normal upper and lower limits of the different measured structures, (c) determine differences in age, side and gender, (d) compare manually and automatically estimated maxillary sinuses volumes, and (e) present incidental findings in the paranasal sinuses among the study patients.     

Respiratory diseases in the late middle ages

Respiratory diseases have beset humanity from the earliest times. The aim of this study was to evaluate the prevalence of respiratory diseases in the inhabitants of a large medieval city. We analyzed 110 skeletons, coming from 12 to 17th century of individuals of either gender. In order to assess pneumatisation of paranasal sinuses and nasal septum curvature, radiographs were performed in the PA projection. Nasal septum deviation was found in 50% of individuals, asymmetry of the frontal sinuses and their aplasia in 11% of individuals. There was no significant relationship between the curvature of the nasal septum and frontal sinus aplasia. One case of tuberculosis and one case of periradicular abscess causing perforation of the maxillary sinus were noted. Developmental variation of the sternum was present in two individuals. In another two individuals, rib fractures with bone union were observed.     

Macro- and mesomorphology of frontal sinuses in humans: Noisiness models relating to their ontogeny

The debate about the role of the frontal sinuses remains unresolved. In this paper, I explore several statistical and fractal features of the frontal sinus outlines in order to better assess the spatial models of supraorbital torus formation. Although the analyses are restricted to a suite of techniques dealing with two-dimensional projections of the frontal sinuses, here I report many features that explain why it is so difficult to describe the spatial models. I show how the outline circumference scales with enclosed area, how the fractal dimensions of the outlines are distributed, how the method of singular value decomposition is used to define surrogate landmarks, and how a principal component analysis of vectors between these landmarks indicates directions of high variability in some of the inferior-distal directions. All these analysis techniques reveal regularities underlying the statistical noise. I believe that uncovering them necessitates a fresh look at the biology of noisy ontogeny phenomena.     

Micro and nanoparticle deposition in human nasal passage pre and post virtual maxillary sinus endoscopic surgery

Realistic 3-D models of the human nasal passages were developed pre and post virtual uncinectomy and Middle Meatal Antrostomy. A 3-D computational domain was constructed by a series of coronal CT scan images from a healthy subject. Then a virtual uncinectomy intervention and maxillary antrostomy were performed on the left nasal passage by removing the uncinate process and exposing the maxillary sinus antrum. For several breathing rates corresponding to low or moderate activities, the airflows in the nasal passages were simulated numerically pre and post virtual routine maxillary sinus endoscopic surgery. The airflow distribution in the nasal airway, maxillary and frontal sinuses were analyzed and compared between pre and post surgery cases. A Lagrangian trajectory analysis approach was used for evaluating the path and deposition of microparticles in the nasal passages and maxillary sinuses. A diffusion model was used for nanoparticle transport and deposition analysis. The deposition rate of the inhaled micro and nanoparticles in the sinuses were evaluated and compared for pre and post operation conditions. The results showed that after maxillary sinus endoscopic surgery, the inhaled nano and microparticles can easily enter this sinus due to penetration of the airflow into the sinus cavity. This was in contrast to the preoperative condition in which almost no particles entered the sinuses. These results could be of importance for a better understanding of the effect of sinus endoscopic surgery on patient exposure to particulate pollution and inhalation drug delivery. The significantly higher airflow rate and particle deposition in the sinus could be a reason for the discomfort reported by some patient after maxillary sinus endoscopic surgery.     

Evaluation of the accuracy of panoramic radiograph in the definition of maxillary sinus septa

The purpose of this study was to determine the accuracy of panoramic radiography in identification of maxillary sinus septa. Out of 68 sinuses were radiographically examined using both panoramic and computerized tomographic radiographs (CT scan). Using CT scan, 24 (35.9%) out of 68 cases maxillae showed at least one septum, 22 sinuses (32.3%) showed one septum, whereas two sinuses (2.9%) exhibited two septa. Panoramic radiograph led to a false diagnosis regarding the presence or absence of sinus septa in 18 of 68 sinuses (26.5%). On the other hand, they gave negative diagnosis of sinus septa in 12 of 24 septa (50%). There was fully agreement between the two methods (positive septa) only in 12 of 24 septa (50%). We cannot depend on panoramic radiograph for the detection of sinus septa because it can lead to false or negative results.