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ANATOMICAL CHARACTERISTICS OF THE FRONTAL SINUS DRAINAGE PATHWAY ACCORDING TO IFAC CLASSIFICATION ON CT SCAN AT ENT HOSPITAL OF HO CHI MINH CITY
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Abstract
Background: The frontal sinus drainage pathway has a complex and varied anatomy, posing a significant challenge in endoscopic sinus surgery. The International Frontal Sinus Anatomy Classification (IFAC 2016) and the International Classification of the radiological Complexity (ICC 2017) are standardized tools that facilitate the assessment of this structural system. This study aimed to describe the anatomical characteristics of the frontal sinus drainage pathway based on IFAC and ICC at ENT Hospital of Ho Chi Minh City. Subjects and Methods: A descriptive case series study. Imaging data were analyzed according to IFAC and ICC 2017 to determine the anteroposterior diameter of the frontal sinus ostium, uncinate process attachment patterns, prevalence of frontal recess cells, and imaging complexity grades. Results: From December 2024 to June 2025, we recorded 90 patients who underwent paranasal sinus CT scans at ENT Hospital of Ho Chi Minh City. The mean age was 47.17 ± 13.76 years, with a balanced male-to-female ratio. Among 180 frontal recesses examined, the mean anteroposterior diameter of the frontal sinus ostium was 5.08 ± 1.77 mm on the right side and 5.45 ± 2.07 mm on the left side (p = 0.221). The majority of uncinate processes attached to the lamina papyracea (>81%), corresponding to drainage into the middle meatus (>81%). Agger Nasi cells were the most common (96.1%), followed by supra bulla cells (49.4%). ICC Grade 3 was the most prevalent complexity grade (Left 50%, Right 43.3%). A statistically significant association was observed between the presence of supraorbital ethmoid cells and the size of the frontal sinus ostium (p = 0.001). Conclusion: The application of IFAC and ICC in routine practice helps standardize CT scan interpretation and provides essential information for planning endoscopic frontal sinus surgery.
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frontal sinus drainage pathway
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