Taiwanese population prevalence of frontal sinus architecture variations and relationships with frontal sinusitis in comparison to worldwide prevalence

Background: Because of its intricate and varied structure, the frontal sinus is difficult to surgically access. In order to improve surgical precision, the International Frontal Sinus Anatomy Classification (IFAC) presents a standardized nomenclature of cells in the frontal sinus and frontal recess. This study examines frontal sinus cell prevalence in Taiwanese and worldwide populations. Methods: In total, 284 sides were gathered from 142 computed tomography (CT) scans in this retrospective analysis during January 2019 to April 2019, with independent assessments for the left and right sides. The IFAC was used to determine the prevalence of each kind of frontal sinus cells. Frontal rhinosinusitis was diagnosed through CT scans and evaluated using the Lund-Mackay score. In addition, the PubMed databases was used to search for articles analyzing the prevalence of frontal sinus cells based on the IFAC. A total of 11 articles were analyzed, including our analysis of the prevalence in the Taiwanese population. (Trial registration: N202305004. Registered 19 May 2023.) Results: With an appearance in 90.5 percent of the patients in the Taiwanese population and 92.5 percent in worldwide, the agger nasi cells were the most frequently occurring cell in both Taiwanese and global populations. In 17.3 percent of instances, frontal sinusitis was present; in 82.8 percent of cases, it was missing. None of the frontal cell variations were shown to be significantly associated with the development of frontal sinusitis (all p > 0.05). Conclusion: This study documents the prevalence of frontal cell types based on the IFAC system in a Taiwanese and the global population. While this article did not establish a direct association between frontal sinus cells and frontal sinusitis, these frontal sinus cells do indeed influence the drainage of frontal sinus secretions. Therefore, comprehensively categorizing frontal sinus cells through the IFAC system can provide valuable insights for future surgeries and related research.