A morphological Study of Anatomical Variations of Frontal Sinus in Adult Libyan People Using CT Scan
DOI:
https://doi.org/10.54361/ljmr.17-18Abstract
Background: The structure of the frontal sinus varies greatly, and these differences influence the onset and progression of clinical diseases. Frontal sinus morphology is unique to each individual and may be used to properly identify people. Aim: The aim of this study is to evaluate the morphometric anatomical variations of the frontal sinus in adult Libyan people using a CT scan in relation to gender. Method and result: 147 patients (78 females and 69 males) were included in this study. Patients were divided into three groups regarding their frontal sinus pneumatization extent on the orbital roof: group 1 pneumatization (small), group 2 pneumatization (medium), and group 3 pneumatization (large). We found that the most common frontal sinus type is medium-sized (37.75 %), followed by the small (24.8%) and large (22.8%) types, respectively. There was no significant difference between the right and left sides in terms of frontal sinus type (P-value = 0,311). We recorded aplasia in 17.7% of all patients, which included (bilateral in 9.5%, left unilateral in 2% and right unilateral in 6.1%). In conclusion, we classified frontal sinuses using the categorization established by Stokovic et al. and showed that pneumatization patterns differ even between two opposite sides of the same individual.
Downloads
References
Drake R, Vogl W, Mitchell A. Gray's Anatomy For Students. 4th ed.; :1064.
Guerram A, Le Minor JM, Renger S, Bierry G. 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.
Al-Balas HI, Nuseir A, Alzoubi F, et al. Prevalence of frontal sinus aplasia in Jordanian individuals. J Craniofac Surg. 2020;31(7):2040-2042.
Baumgartner EA, Louis S. the Development O F the Hypophysis I N. Anat Rec. 1918;15(2):73-92.
Aslıer NGY, Zeybek G, Karabay N, et al. The Relationships Between Craniofacial Structure and Frontal Sinus Morphology: Evaluation With Conventional Anthropometry and CT-Based Volumetry. Ear, Nose Throat J. 2020;99(10):637-647.
Sinnatamby CS Last RJ. Last's Anatomy : Regional and Applied. 10th ed. Edinburgh: Churchill Livingstone; 1999.
Moore K, Dalley A, Agur A. Clinically Oriented Anatomy. 7th ed.; :961.
Yüksel Aslier NG, Karabay N, Zeybek G, et al. Computed tomographic analysis: The effects of frontal recess morphology and the presence of anatomical variations on frontal sinus pneumatization. J Craniofac Surg. 2017;28(1):256-261.
Harris AM, Wood RE, Nortjé CJ, Thomas CJ. The frontal sinus: forensic fingerprint? A pilot study. J Forensic Odontostomatol. 1987;5(1):9-15.
Song X, Zhao B, Wang C, Wang N. Dynamic Response of the Skull with Sinuses under Blunt Frontal Impact: A Three-Dimensional Computational Study. Comput Math Methods Med. 2015;2015:848079.
Gotlib T, Kuźmińska M, Held-Ziółkowska M, Osuch-Wójcikiewicz E, Niemczyk K. Hidden unilateral aplasia of the frontal sinus: a radioanatomic study. Int Forum Allergy Rhinol. 2015;5(5):441-444.
Štoković N, Trkulja V, Čuković-Bagić I, Lauc T, Grgurević L. Anatomical variations of the frontal sinus and its relationship with the orbital cavity. Clin Anat. 2018;31(4):576-582.
Schuller A. Note on the identification of skulls by X-ray pictures of the frontal sinuses. Med J Aust 1943;1:554-6
Szilvassy J. Die Stirnhohlen der Schadel aus dem awarischen Graberfeld von Zwolfaxing in Niedero sterreich. Ann Naturhist Mus Wien 1974;78:109-18
Yoshino M, Miyasaka S, Sato H, Seta S. Classification system of frontal sinus patterns by radiography. Its application to identification of unknown skeletal remains. Forensic Sci Int. 1987;34(4):289-299. doi:10.1016/0379-0738(87)90041-7
Koertvelyessy T. Relationships between the frontal sinus and climatic conditions: a skeletal approach to cold adaptation. Am J Phys Anthropol. 1972;37(2):161-172. doi:10.1002/ajpa.1330370202
Ikeda J. Interpopulation variations of the frontal sinus measurements: comparison between the Jomon and recent Japanese population. J Anthrop Soc Nippon Suppl 1980:90:91-104
Hanson CL, Owsley DW. Frontal sinus size in Eskimo populations. Am J Phys Anthropol. 1980;53(2):251-255.
Szilvassy J. Zur Variation, Entwicklung und Vererbung der Stirnhohlen. Ann Naturhist Mus Wien 1982;84A: 97-125
Nowak R, Mehls G. Die aplasien der sinus maxillares und frontales unter besenderer Berucksichtigung der pneumatisation bei spalttragern. Anat Anz 1977;142: 441-50
Aydinlioǧlu A, Kavakli A, Erdem S. Absence of frontal sinus in Turkish individuals. Yonsei Med J. 2003;44(2):215-218.
Tatlisumak E, Ovali GY, Asirdizer M, et al. CT study on morphometry of frontal sinus. Clin Anat. 2008;21(4):287-293.
Çakur B, Sumbullu MA, Durna NB. Aplasia and agenesis of the frontal sinus in Turkish individuals: a retrospective study using dental volumetric tomography. Int J Med Sci. 2011;8(3):278-282.
Özdemir M, Kavak RP, Öcal B, Soysal H. A novel anatomical classification of the frontal sinus: can it be useful in clinical approach to frontal sinusitis? Egypt J Otolaryngol. 2021;37(1).
Uthman AT, Al-Rawi NH, Al-Naaimi AS, Tawfeeq AS, Suhail EH. Evaluation of frontal sinus and skull measurements using spiral CT scanning: an aid in unknown person identification. Forensic Sci Int. 2010;197(1-3):124.e1-124.e1247.
Camargo JR, Daruge E, Prado FB, et al. The frontal sinus morphology in radiographs of Brazilian subjects: Its forensic importance. Brazilian J Morphol Sci. 2007;24(4):239-243.
Pondé JM, Nonato Andrade R, Maldonado Via J, Metzger P, Teles AC. Anatomical Variations of the Frontal Sinus. Int J Morphol. 2008;26(4):803-808.
Shireen A, Goel S, Ahmed IM, Sabeh AM, Mahmoud W. Radiomorphometric Evaluation of the Frontal Sinus in Relation to Age and Gender in Saudi Population. J Int Soc Prev Community Dent. 2019;9(6):584-596.
Belaldavar C, Kotrashetti VS, Hallikerimath SR, Kale AD. Assessment of frontal sinus dimensions to determine sexual dimorphism among Indian adults. J Forensic Dent Sci. 2014;6(1):25-30.
Nambiar P, Naidu MD, Subramaniam K. Anatomical variability of the frontal sinuses and their application in forensic identification. Clin Anat. 1999;12(1):16-19.
Published
Issue
Section
License
Copyright (c) 2023 Asil. A .Almasheety, Mustafa A Karwad, Murshed H. Haidar (Author)

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Open Access Policy
Libyan journal of medical Research (LJMR).is an open journal, therefore there are no fees required for downloading any publication from the journal website by authors, readers, and institution.
The journal applies the license of CC BY (a Creative Commons Attribution 4.0 International license). This license allows authors to keep ownership f the copyright of their papers. But this license permits any user to download , print out, extract, reuse, archive, and distribute the article, so long as appropriate credit is given to the authors and the source of the work.
The license ensures that the article will be available as widely as possible and that the article can be included in any scientific archive.
Editorial Policy
The publication of an article in a peer reviewed journal is an essential model for Libyan journal of medical Research (LJMR). It is necessary to agree upon standards of expected ethical behavior for all parties involved in the act of publishing: the author, the journal editorial, the peer reviewer and the publisher.
Any manuscript or substantial parts of it, submitted to the journal must not be under consideration by any other journal. In general, the manuscript should not have already been published in any journal or other citable form, although it may have been deposited on a preprint server. Authors are required to ensure that no material submitted as part of a manuscript infringes existing copyrights, or the rights of a third party.
Authorship Policy
The manuscript authorship should be limited to those who have made a significant contribution and intellectual input to the research submitted to the journal, including design, performance, interpretation of the reported study, and writing the manuscript. All those who have made significant contributions should be listed as co-authors.
Others who have participated in certain substantive aspects of the manuscript but without intellectual input should only be recognized in the acknowledgements section of the manuscript. Also, one of the authors should be selected as the corresponding author to communicate with the journal and approve the final version of the manuscript for publication in the LJMR.
Peer-review Policy
- All the manuscripts submitted to LJMR will be subjected to the double-blinded peer-review process;
- The manuscript will be reviewed by two suitable experts in the respective subject area.
- Reports of all the reviewers will be considered while deciding on acceptance/revision or rejection of a manuscript.
- Editor-In-Chief will make the final decision, based on the reviewer’s comments.
- Editor-In-Chief can ask one or more advisory board members for their suggestions upon a manuscript, before making the final decision.
- Associate editor and review editors provide administrative support to maintain the integrity of the peer-review process.
- In case, authors challenge the editor’s negative decision with suitable arguments, the manuscript can be sent to one more reviewer and the final decision will be made based upon his recommendations.