Vol 81, No 4 (2022)
Original article
Published online: 2021-11-05

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Extent of the frontal sinuses in the aspect of neurosurgical craniotomy approaches

Z. Siedlecki1, M. Sabramowicz2, J. Woźniak1, M. Śniegocki1, K. Nowak1, M. Baumgart2, E. Główczewska-Siedlecka3, M. Szpinda2, M. Wiśniewski2
Pubmed: 34750802
Folia Morphol 2022;81(4):1047-1053.

Abstract

Background: Frontal sinuses within the frontal bone can be a potential obstacle in neurosurgical approach in this region. Their unintended opening during craniotomy is not beneficial due to the risk of brain infections by bacteria inhabiting the sinus mucosa. Therefore, such opening should be avoided whenever the surgical procedure does not involve the sinus itself. The aim of the study was the morphometric analysis of the frontal sinuses based on computed tomography imaging.
Materials and methods: The width, height, projection surface area and location of the highest and most lateral points of the sinuses were determined.
Results: The vertical diameter of the sinuses was found to be greater in men compared with women. The most lateral point of the sinuses was located higher in men, and in men was located higher on the left side. The results obtained may indicate that the frontal sinuses tend to be larger in men and that air cells in men extend further in the upper-lateral direction on the left side of the frontal bone.
Conclusions: This may cause an increased risk of unintentional opening of the left frontal sinus during frontal craniotomy or pterional craniotomy with frontal extension.

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References

  1. Başal Y, Başak S, Bedrosian JC. Surgical Anatomy of the Paranasal Sinuses. In All Around the Nose. Springer, Cham 2020: 49–55.
  2. Buller J, Kreppel M, Maus V, et al. Risk of frontal sinus anterior table fractures after craniofacial trauma and the role of anatomic variations in frontal sinus size: A retrospective case-control study. J Craniomaxillofac Surg. 2019; 47(4): 611–615.
  3. Duque CS, Casiano RR. Surgical anatomy and embryology of the frontal sinus. In The frontal sinus. Springer, Berlin, Heidelberg 2005: 21–31.
  4. Fatu C, Puisoru M, Rotaru M, et al. Morphometric evaluation of the frontal sinus in relation to age. Ann Anat. 2006; 188(3): 275–280.
  5. Friedman M, Bliznikas D, Vidyasagar R, et al. Frontal sinus surgery 2004: update of clinical anatomy and surgical techniques. Operative Techniques Otolaryngology-Head Neck Surgery. 2004; 15(1): 23–31.
  6. Guerram A, Le Minor JM, Renger S, et al. Brief communication: the size of the human frontal sinuses in adults presenting complete persistence of the metopic suture. Am J Phys Anthropol. 2014; 154(4): 621–627.
  7. Kew J, Rees GL, Close D, et al. Multiplanar reconstructed computed tomography images improves depiction and understanding of the anatomy of the frontal sinus and recess. Am J Rhinol. 2002; 16(2): 119–123.
  8. Lee D, Brody R, Har-El G. Frontal sinus outflow anatomy. Am J Rhinol. 1997; 11(4): 283–285.
  9. Lee MK, Sakai O, Spiegel JH. CT measurement of the frontal sinus - gender differences and implications for frontal cranioplasty. J Craniomaxillofac Surg. 2010; 38(7): 494–500.
  10. McLaughlin RB, Rehl RM, Lanza DC. Clinically relevant frontal sinus anatomy and physiology. Otolaryngol Clin North Am. 2001; 34(1): 1–22.
  11. Tatlisumak E, Ovali GY, Asirdizer M, et al. CT study on morphometry of frontal sinus. Clin Anat. 2008; 21(4): 287–293.