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Standard plain film medical radiographs often form a valuable line of evidence to identify individuals in large‐scale fatality events. While commonly available, chest radiographs present a challenge that their analysis is somewhat more involved and complex than radiographic records of other body regions. For example, chest radiographs concern subtler morphological varieties of smaller anatomical features across a larger number of skeletal elements in contrast to frontal sinus comparisons that concern a large, (often) single, highly variable void within one bone. This does not detract from or discount chest radiographs as useful identification aids, but it does demand additional prerequisite skills in radiographic interpretation to ensure valid conclusions are attained. When subjects deviate from standardized antemortem (AM) radiographic positions and/or the image quality decreases, the complexity of a chest radiograph comparison is elevated. Generally, the current body of forensic radiographic comparison literature infrequently addresses these more complex circumstances. In this paper, we use real‐world radiographic comparison reference images from a military DVI repatriation context to illustrate these factors and outline some procedures that enable these complexities to be easily recognized and appropriately addressed at case examination. A report for an exemplar case that concurrently highlights multiple factors is presented. For novices learning radiographic comparison methods, this case review saliently demonstrates: (1) why the AM reference radiograph(s) drive(s) the radiographic comparison procedure; (2) why care should be taken for correct positioning of the cervicothoracic junction in postmortem radiography of chest elements. [ABSTRACT FROM AUTHOR]

Mucoceles of the paranasal sinuses are benign, expansile lesions that develop secondary to sinus ostia obstruction. Presenting signs and symptoms vary widely but frequently include frontal headache and swelling, as well as visual changes and globe displacement depending on orbital involvement in the case of frontal sinus mucoceles. Given the potential for orbital or intracranial involvement, urgent imaging with computed tomography (CT) is important for patients with symptoms concerning for a frontal sinus mucocele. Definitive treatment is surgical. In this article, we report a case of a 50-year-old male who presented to a primary care clinic with a painful forehead mass, found to have a frontal sinus mucocele with erosion through the frontal bone that was eventually treated surgically. We also summarize presenting signs and symptoms of frontal mucoceles reported in the literature as these are important for clinicians to be familiar with, considering the potential emergent complications. [ABSTRACT FROM AUTHOR]

Since its inception, the International Anatomical Terminology has been an indispensable and widely embraced resource for authors, anatomists, researchers, and medical professionals, ensuring standardized anatomical terminology across various disciplines. Nonetheless, it is widely acknowledged that periodic updates and enhancements are necessary to incorporate the latest scientific knowledge and advancements in imaging techniques. The current version of Terminologia Anatomica includes a section dedicated to the paranasal sinuses, encompassing ethmoidal cells and three sinuses: frontal, sphenoidal, and maxillary. However, the anatomical lexicon pertaining to the paranasal sinuses is more extensive. In clinical practice, multiple terms related to clinically significant structures are commonly employed. This article focuses on the clinical terminology associated with the paranasal sinuses, proposing significant extensions to the existing Terminologia Anatomica. These extensions aim to enrich the anatomical nomenclature and facilitate a harmonious convergence between the language of clinicians and the anatomical lexicon. Further endeavors should bridge the gap in anatomical nomenclature and improve communication between anatomists, researchers, and clinicians, thereby enhancing diagnostic accuracy and improving interdisciplinary research collaboration. [ABSTRACT FROM AUTHOR]

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We present a novel case of intraosseous venous malformation of the frontal bone with dehiscence of the inner table of the frontal calvarium and extension into the frontal sinus and orbit. This case report discusses the surgical management of this intraosseous lesion achieved with a multidisciplinary approach involving otolaryngology and neurosurgical teams. We also present a review of the literature of the pathophysiology of venous malformations, the imaging modalities that aid in diagnosis of these lesions and the management options. [ABSTRACT FROM AUTHOR]

Objective: The frontal sinus remains a challenging site for irrigation due to its position relative to the nostril and ethmoid sinus. This study aims to summarize the necessary factors for efficient irrigation of the frontal sinus after endoscopic sinus surgery (ESS) among patients with chronic rhinosinusitis (CRS). Methods: Using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, a systematic literature review was conducted on PubMed, Scopus, and Cochrane databases to identify studies assessing the effect of frontal sinus irrigation in patients with CRS, cadaver models, or 3D-printed models of the sinonasal cavity after ESS. Results: Of the initial 206 abstracts reviewed, 18 full-text articles were included. The degree of the frontal sinus ostium opening after ESS was found to be associated with the efficacy of frontal sinus irrigation. More extensive frontal sinus surgeries tended to increase frontal sinus penetration. A Draf IIA procedure was identified as the minimum standard to achieve sufficient irrigation in the frontal sinus. Due to decreased backpressure in the nasal passage, increasing septectomy in Draf III did not significantly improve irrigation delivery. Squeeze bottles achieved significantly higher irrigation flow in the frontal sinus than syringes and pulsating devices. Large-volume irrigation devices provided better irrigation for the frontal sinus by entering or flushing the entire frontal sinus. The head position influenced the frontal sinus irrigation by altering the ostia position relative to fluid flow and vertical height of the frontal sinus during irrigation. While the vertex down head position was likely to enhance frontal sinus irrigation, the comfort of the head position and patient compliance should be considered. Conclusion: Elements for optimization of frontal sinus irrigation are a minimum of a Draf IlA procedure for frontal sinus dissection, use of large-volume irrigation, and vertex down head positioning. Developing comfortable head positions with high frontal sinus irrigation efficiency would increase patient compliance and improve outcomes. Level of Evidence: NA. [ABSTRACT FROM AUTHOR]

A 59-year-old woman presented to our clinic with a 3.5× 3-cm protruding mass on her forehead. A skull X-ray revealed a radiolucent osteolytic lesion on the left side of the frontal bone. Additionally, computed tomography showed a 3.1× 1.7× 3.6-cm mass exhibiting a “sunburst” pattern situated between the outer and inner tables of the skull, just superior and lateral to the left frontal sinus. This pattern suggested the presence of an intraosseous vascular malformation (IVM). The lesion was approached via a bicoronal incision. En-bloc resection was performed, removing the mass along with approximately 0.5 cm of the surrounding normal bone without injury to the exposed frontal sinus mucosa. The exposed mucosa was reinforced with a galeal flap, and cranioplasty with bone cement was performed to repair the resulting bony defect. Pathological examination confirmed a diagnosis of intraosseous cavernous-type malformation with mixed cavernous and capillary histological features. We report this case of IVM and review the existing literature, highlighting the satisfactory functional and aesthetic outcomes after surgery. [ABSTRACT FROM AUTHOR]

We report a case of a 58-year-old man with a history of nasal obstruction and recurrent epistaxis who underwent videonasolaryngoscopy after 9 months of symptoms. The frst images showed a hyperemic mass affecting the left middle turbinate up to the nasal cleft. Computed tomography described a mass with an expansive effect occupying the entire left frontal sinus and most of the left ethmoid cells, widening the frontal sinus drainage path, and creating a continuity break of the cribriform plate, the left papyraceous lamina, and the upper-third of the nasal septum. Magnetic resonance imaging suggested T1-isointensity and T2-hyperintensity, intense contrast uptake, and no involvement of meningeal or brain tissues. The patient underwent extended endoscopic surgery without previous endovascular embolization or adjuvant therapies. A contralateral inferior turbinate graft was applied over the cribriform plate. Histopathological examination suggested glomangiopericytoma (GPC), and immunohistochemistry confrmed the diagnosis with positive beta-catenin, smooth muscle actin, and cyclin D1. The patient presented no nasal symptoms up to a 9-month follow-up. Nasal endoscopy showed no tumor recurrence signal. Although fronto-ethmoidal GPC is a rare tumor and presents challenging surgical access, it can be safely excised by endoscopic surgery. However, careful short- and long-term endoscopic follow-ups remain necessary to prevent postoperative complications and maintain surveillance of recurrences. [ABSTRACT FROM AUTHOR]

Osteomyelitis is a bone inflammation caused by an infectious microorganism, which may lead to complete structure decay. Over time, along with the discovery and usage of powerful antibiotics, it became a rare occurrence in modern practice. In this paper, we will present a case of a patient with craniofacial osteomyelitis, which occurred as a complication of previous trauma and incomplete surgical treatment, due to lack of compliance. Chronic diseases in the non-cooperative patient led to the development of a severe clinical state. We believe that the existence of communication between defects on the anterior wall of the frontal sinus and corresponding subcutaneous and cutaneous tissue may have prevented further complications, in particular endocranial. Despite of a severe local finding, there was no dramatic increase in inflammatory parameters in laboratory analysis, as expected in such cases. A careful diagnostic procedure, identification of causative agent, adequately applied antibiotic therapy followed by surgical treatment debridement, improved the general condition of the patient as well as local finding. A severe form of osteomyelitis of the facial bones can be a complication after facial bone osteosynthesis. The absence of endocranial complications can be explained by drainage of purulent content through defects in the skin of the face. Quick and precise diagnostics, followed by treatment that includes a combination of surgery and conservative treatment, give the best results in such complex conditions. [ABSTRACT FROM AUTHOR]

Introduction: International frontal sinus anatomy classification (IFAC) was introduced in 2016 to standardize the nomenclature of the cells in the frontal recess region, facilitate better communication between surgeons and precision in surgical planning, and improve surgical teaching. This study aims to estimate the radiological prevalence of the different frontal recess cells according to the IFAC and to evaluate the relationship of these cells with the frontal sinus opacification in patients with chronic rhinosinusitis. Methods: In this study, 90 participants diagnosed with chronic rhinosinusitis (CRS) who underwent computed tomogram (CT) of the para nasal sinuses were enrolled consecutively. The CT images were were studied in detail using RadiAnt DICOM viewer. The frontal recess cells were grouped as per the IFAC guidelines and their respective prevalence was calculated. The frontal recess cells were grouped as per the Opacification or mucosal thickening within these cells and the frontal sinuses were noted. A multivariate logistic regression analysis was done to evaluate the association between frontal sinus opacification and presence of various IFAC cells. Results: A total of 640 IFAC cells were documented in 180 sides, of which 326 were anterior cells, 263 were posterior cells and 51 were medial cells. The most prevalent cell was the agger nasi cells(ANC), present in 91.7% of 180 sides, the supra agger nasi cells(SANC), Supra agger nasi frontal cells(SAFC), supra bulla cells(SBC), supra bulla frontal cells(SBFC), supra orbital ethmoidal cells(SOEC) and frontal septal cells(FSC) were present in 47.8%,37.8%, 65.6%,28.9%, 51.1% and 28.3% respectively. There was no significant association of presence of IFAC cells and frontal sinus opacification except for SBFC(p = 0.038). A significantly higher number of diseased frontal recess cells were seen with involved frontal sinuses when compared with non-involved frontal sinuses across all types of IFAC cells. Conclusion: The ANC were the most prevalent among all the IFAC cells and the FSC were the least prevalent. There was no significant association with the presence of different types of IFAC cells and frontal sinus opacification except for SBFC. However, there was a significantly higher number of diseased IFAC cells associated with frontal sinus opacification than in those without frontal sinus opacification. [ABSTRACT FROM AUTHOR]

Computerized Surgical Planning (CSP) is a surgical tool that enables precise bony changes through the creation of custom cutting guides and/or custom plates. CSP has been shown to be a safe and effective tool in gender affirming facial surgery as well, specifically with regard to frontal sinus setback, zygomatic remodeling, genioplasty, and mandibular angle and body reshaping. CSP aids in trainee education, improves symmetry, reduces operative time, and can produce idealized results during complex revisions. Overall, CSP is a valuable tool in the field of gender affirming facial surgery that helps surgeons achieve optimal aesthetic and safety outcomes for patients. [ABSTRACT FROM AUTHOR]

This case report highlights a unique presentation of Erdheim-Chester Disease (ECD) with bilateral scleral lesions, choroidal infiltration, and extensive sinus involvement. It is the first case report where the diagnosis was confirmed through a scleral biopsy after an initial presentation of a unilateral nodular scleritis. There was a gradual disease progression and ocular examination later revealed bilateral subconjunctival hyperemic lesions and mild exophthalmos, ophthalmoplegia, and extensive choroidal infiltration. Infiltration of the frontal and maxillary sinus was present and extended into the nasal cavity and both orbits. The diagnostic work-up is described in detail. Current treatment options are analyzed. It is emphasized that the ophthalmologist can play a crucial role in the diagnosis of ECD, given the substantial prevalence of orbital and ocular symptoms. The overall prognosis for ECD remains unfavorable, particularly in cases with orbital involvement. This case underscores the complexity and importance of a multidisciplinary approach in managing ECD. [ABSTRACT FROM AUTHOR]

Background: Prognostic factors in dogs with nasal tumors include several variables. However, factors that can measure prognosis have not yet been identified due to considerable divergence among reports. Aim: To describe the computed tomography (CT) imaging, treatment, and outcomes of dogs with nasal tumors, as well as detect negative prognostic factors through the analysis of a substantial number of cases from a single institution. Furthermore, based on CT findings, this study aimed to identify independent prognostic factors for nasal tumors in dogs. Methods: A total of 166 client-owned dogs were diagnosed with nasal tumors at Gifu University Veterinary Hospital between 2015 and 2019. Data were retrospectively collected from the electronic medical records. Results: Univariate analysis revealed a significant difference in survival time between adenocarcinoma and squamous cell carcinoma in 166 canine nasal tumors treated with megavoltage (MeV) radiation therapy at a single institution (p = .015). There was a significant difference in survival time between carcinoma and sarcoma (p = .04). Regarding CT imaging findings, significant differences in survival time were observed for frontal sinus invasion (p = .007), cribriform plate destruction (p < .001), and lymph node metastasis (p = .003). Multivariate Cox regression analysis was performed to assess frontal sinus invasion, cribriform plate destruction, histopathologic subtypes, and lymph node metastasis as negative prognostic factors; however, only cribriform plate destruction was a significant negative prognostic factor for survival time (p = .004). Conclusion: Multivariate Cox regression analysis showed that cribriform plate destruction was the main factor in predicting a negative prognosis among 166 canine nasal tumors treated with MeV radiation therapy at a single institution. Therefore, we propose a new 2-tier staging classification for canine nasal tumors with the presence or absence of cribriform plate destruction based on CT examination as the only evaluation factor. [ABSTRACT FROM AUTHOR]

Sinus mucoceles are nonmalignant cystic tumors lined by non-neoplastic epithelium, typically involving the frontal and ethmoid sinuses. Although it is common for these mucoceles to cause destruction of surrounding bone tissue due to their growth, cerebrospinal fluid leaks resulting from skull base penetration by an ethmoid sinus mucocele have rarely been reported. A 24-year-old male patient presented with right proptosis and right periorbital pain, who underwent bilateral endoscopic sinus sur gery 12 years ago. Endoscopic sinus surgery was performed to treat the right ethmoid sinus mucocele, and confirmed the presence of a basal skull de fect during surgery. We reconstructed the skull base defect using septal cartialge and free mucosal graft. The symptoms were completely resolved after surgery and no cerebrospinal fluid leakage was noted during follow up period. This case report highlights a rare instance of direct mucocele extension to the skull base. [ABSTRACT FROM AUTHOR]

Recalcitrant frontal sinusitis in patients with chronic rhinosinusitis and nasal polyps (CRSwNP) has a negative impact on their quality of life due to frontal pain and a high risk of sinus occlusion, thus necessitating antibiotics, systemic corticosteroids, and multiple surgeries. The aim of this study was to assess the efficacy of dupilumab in reducing frontal pain and the need for rescue treatments for recalcitrant frontal sinusitis in patients with CRSwNP. We enrolled a cohort of 10 patients with severe uncontrolled CRSwNP and concomitant recurrent frontal sinusitis associated with severe facial pain measured by MIDAS score who were treated with dupilumab 300 mg every 2 weeks and followed for at least 12 months. The mean MIDAS score decreased from 45.6 ± 10.7 at baseline to 1.3 ± 2.3 at 6 months (p < 0.05). VAS craniofacial pain decreased from 7.3 ± 1.6 at baseline to 1.2 ± 1.5 at 6 months (p < 0.05). No patient needed oral corticosteroids during treatment with dupilumab (p < 0.05), and the use of analgesics decreased from 9.6 ± 3.1 NSAID pills/week in the last 2 months at baseline to 0.6 ± 1.3 at 1 year of follow-up (p < 0.05). Our results demonstrated that use of subcutaneous dupilumab can improve symptom control, including recurrent severe cranio-facial pain, and reduce the need for rescue medical treatments (systemic steroids and NSAID) in patients with severe uncontrolled CRSwNP and concomitant recurrent frontal sinusitis. [ABSTRACT FROM AUTHOR]

Several code‐based methods have been created for comparing the frontal sinus in skeletal identification scenarios. However, little is known regarding matched‐pair accuracy rates of these methods or how varying image modalities may affect these rates. The goals of this study were to validate the exclusion rates and to establish matched‐pair accuracy rates of two well‐cited coding methods, Cameriere et al. [23] and Tatlisumak et al. [24]. Additionally, individual variables were assessed for consistency in scoring between image modalities. Using a sample of U.S. African American, Native American, and European American females and males (n = 225), we examined individual variable scoring and string codes between two different image modalities (radiographs and CT‐based 3D models). Arcades showed poor scoring consistency between modalities (p < 0.001). Although exclusion rates were similar to those reported in the original studies (93%–96%), matched‐pair accuracy rates were low (13%–18%). None of the demographics (collection, sex, age, ancestry, and orientation) had an effect on the odds of a match. Interobserver and intraobserver analyses showed moderate to near‐perfect agreement for all variables except supraorbital cells, which had minimal to no agreement. Currently, we do not recommend the application of these frontal sinus coding methods independent of other supporting identification methods given low variable consistency and accuracy rates. Visual identification should still be used to include or exclude an identification when using the frontal sinus. [ABSTRACT FROM AUTHOR]

This article discusses a study on fungal sinus aspergilloma (FSA), a rare condition characterized by the presence of fungal growth in the sinuses. The study included six patients with FSA and found that the frontal sinus was involved in one patient, while bilateral infection was reported in another case. The most common symptom was headache. The study also compared the incidence of bone erosion in FSA with other types of fungal sinusitis and found that FSA had a higher incidence of bone erosion. The authors suggest that recognizing the radiological features of FSA and obtaining tissue samples for analysis are important for accurate diagnosis and treatment planning. [Extracted from the article]

OBJECTIVES. Hyperostosis frontalis interna (HFI) is a condition that involves the non-cancerous growth of the inner part of the frontal bone. We investigated diffuse HFI in cranial CT in terms of bone thickness and density. MATERIAL AND METHODS. The cranial CT images of 154 adult patients with diffuse HFI and 151 adult patients without HFI were included in the study. Bone thickness measurements were performed at vertex, frontal tuberosity and frontal sinus levels in the midline, right and left lateral parts. Density measurements were also performed in the same areas. In the HFI group, measurements were performed at the HFI and non-HFI regions. In the control group, density measurements were also performed. RESULTS. HFI was detected more in females (96.1%). In diffuse HFI patients, bone thickness values increased at the vertex, frontal tuberosity and frontal sinus levels (p<0.05). Bone densities of the HFI parts increased at vertex and frontal tuberosity levels (p<0.05). In the HFI group, there were positive correlations between bone thicknesses (p<0.05). As bone thicknesses increased, bone density values decreased (p<0.05). In older patients, frontal tuberosity and frontal sinus bone densities decreased (p<0.05). CONCLUSION. HFI may be one of the reasons for headaches in females. In the future, it would be better to investigate the relationship between HFI and headaches. The physicians should notice that increased bone thickness may be the sign of the HFI and they should consult with the Radiology Department. When HFI is detected, an endocrinological assessments will also be performed. [ABSTRACT FROM AUTHOR]

Objectives An important aspect of forensic investigation is determining the sex of an unidentified person. The frontal sinus is unique and remains intact, thus making it suitable for forensic analysis. The main objective of this study is to determine the sex of an individual by frontal sinus using a multidetector computed tomography scan. Materials and Methods A total of 100 patients (50 males and 50 females) were included in the study, and different parameters of the frontal sinus for both sides were analyzed, that is height, width, depth, and total length. Statistical Analysis Descriptive statistics of all the variables were computed and compared. SPSS version 16 was used to perform the Mann–Whitney U test, binary logistic regression, and receiver operating characteristic (ROC) curve analysis on the acquired data. Results The result suggested that males have higher mean values than females, with the left frontal sinus height being the only variable to be statistically significant (p < 0.05). Based on the ROC curve analysis, the optimum cutoff value was 0.489, which means if the predicted probability value was less than 0.489, the individual was considered a male; and if the predicted probability value was ≥0.489, the individual was considered a female. The accuracy of the mathematical model based on binary logistic regression analysis for determining sex was 70% for females and 66% for males. Conclusion The present study plays a significant role in determining sex in the Indian population by using left frontal sinus height measurement through a multidetector computed tomography scan. [ABSTRACT FROM AUTHOR]

Abstract Sex determination is essential for identifying unidentified individuals, particularly in forensic contexts. Traditional methods for sex determination involve manual measurements of skeletal features on CBCT scans. However, these manual measurements are labor-intensive, time-consuming, and error-prone. The purpose of this study was to automatically and accurately determine sex on a CBCT scan using a two-stage anatomy-guided attention network (SDetNet). SDetNet consisted of a 2D frontal sinus segmentation network (FSNet) and a 3D anatomy-guided attention network (SDNet). FSNet segmented frontal sinus regions in the CBCT images and extracted regions of interest (ROIs) near them. Then, the ROIs were fed into SDNet to predict sex accurately. To improve sex determination performance, we proposed multi-channel inputs (MSIs) and an anatomy-guided attention module (AGAM), which encouraged SDetNet to learn differences in the anatomical context of the frontal sinus between males and females. SDetNet showed superior sex determination performance in the area under the receiver operating characteristic curve, accuracy, Brier score, and specificity compared with the other 3D CNNs. Moreover, the results of ablation studies showed a notable improvement in sex determination with the embedding of both MSI and AGAM. Consequently, SDetNet demonstrated automatic and accurate sex determination by learning the anatomical context information of the frontal sinus on CBCT scans.

Objective: Gender determination is pivotal in establishing a biological profile of human remains, where fragments of the skull persist with unidentifiable dental arch data. Owing to the resistance and stability against external factors such as trauma and fractures, radiological assessment of the frontal sinus can be a useful indicator for sexual dimorphism. Keeping this in mind, a study was designed to analyse the efficacy of morphometric assessment of the frontal sinus for gender determination in the North Indian population. Materials and Method: A total of 300 (150 males and 150 females) lateral cephalograms of the age >20 years were retrieved. The frontal sinus index (ratio of maximum height to depth), area, and perimeter of the same were calculated using Adobe Photoshop software. The results obtained were further subjected to statistical analysis. Result and Conclusion: The study yielded an accuracy rate of 75.3% for sex differentiation. The frontal sinus perimeter was a novel parameter which was utilised as a variable in the obtained discriminant equation for sex differentiation. Thus, this cost-effective technique might be useful as an adjunct to assess sexual dimorphism.

Sinonasal malignant tumors are a group of uncommon malignancies that account for less than 1% of all tumors. These tumors often involve the maxillary sinus and nasal cavity, with less cumulative incidence in the ethmoidal sinus, sphenoidal sinus, and frontal sinus. The lack of consensus on the management of sinonasal malignancies is due to their rarity, diagnostic challenges, and the heterogeneity of treatments. In this paper, we present a case of endoscopic-assisted medial canthus incision combined with radiotherapy in the treatment of sinonasal malignant tumors, with the aim of providing valuable insights to clinicians on the management of these tumors. [ABSTRACT FROM AUTHOR]

The paranasal sinuses, a bilaterally symmetrical system of eight air-filled cavities, represent one of the most complex parts of the equine body. This study aimed to extract morphometric measures from computed tomography (CT) images of the equine head and to implement a clustering analysis for the computer-aided identification of age-related variations. Heads of 18 cadaver horses, aged 2–25 years, were CT-imaged and segmented to extract their volume, surface area, and relative density from the frontal sinus (FS), dorsal conchal sinus (DCS), ventral conchal sinus (VCS), rostral maxillary sinus (RMS), caudal maxillary sinus (CMS), sphenoid sinus (SS), palatine sinus (PS), and middle conchal sinus (MCS). Data were grouped into young, middle-aged, and old horse groups and clustered using the K-means clustering algorithm. Morphometric measurements varied according to the sinus position and age of the horses but not the body side. The volume and surface area of the VCS, RMS, and CMS increased with the age of the horses. With accuracy values of 0.72 for RMS, 0.67 for CMS, and 0.31 for VCS, the possibility of the age-related clustering of CT-based 3D images of equine paranasal sinuses was confirmed for RMS and CMS but disproved for VCS. [ABSTRACT FROM AUTHOR]

Objective: Researchers have extensively investigated the reasons behind variations in the volumes of paranasal sinuses, either among different individuals or between the right and left sides of the same individual. These differences in volumes have been associated with nasal septal deviation (NSD) and anatomical variations. In this study, we aimed to retrospectively analyzed the effect of NSD on frontal sinus, maxillary sinus, and sphenoidal sinus. Material and Method: A total of 281 patients (151 females and 130 males) admitted to Gaziosmanpaşa University Hospital were included in the study. Paranasal sinus computed tomography (CT) images consisting of 0.625-mmthick slices were obtained from the patients. The areas of the frontal sinus, maxillary sinus, and sphenoidal sinus were determined using ImageJ software. The volume of each sinus was calculated using Cavalieri's principle. We analyzed the relationship between the calculated volumes and nasal septal deviation. Results: Our study found that the frontal sinus volume values were 4.67 cm³ on the right side and 5.03 cm³ on the left side in women. In men, the right-side volume value was 7.07 cm³ and the left-side volume value was 7.77 cm³. The sphenoidal sinus volume value was calculated as 6.35 cm³ on the right side and 6.57 cm³ on the left side in women. In males, the right-side volume value was 7.34 cm³ and the left-side volume value was 7.62 cm³. The maxillary sinus volume was calculated as 19.38 cm³ on the right side and 19.37 cm³ on the left side in women. In males, the right-side volume value was 22.80 cm³ and the left-side volume value was 23.71 cm³. The frontal sinus volume values in males were larger than those in females (p=0.04). The maxillary sinus volume values in males were greater than the maxillary sinus volume values in females (p=0.02). There was no significant relationship between the presence of septal deviation and sinus volumes (p>0.05). The right, left, or s-shaped deviation direction did not cause a significant difference in sinus volumes (p>0.05). Conclusion: The findings show that there is no correlation between volume values and the presence and shape of nasal septal deviation. However, significant differences in volumes were observed between the genders. Because the severity of nasal septal deviation is related to the volume value, different results can be obtained by measuring the frontal sinus, maxillary sinus, and sphenoidal sinus volume values in individuals with more advanced deviation. [ABSTRACT FROM AUTHOR]

Large defects of frontal sinus (FS) might be difficult to manage effectively. Mismanagement of the large defects could lead to serious postoperative complications in anterior skull base surgery. This study introduces a simple and reliable method applying small supporting bone pieces to cover or insert into large FS defects, then the large defect of FS was transformed into the small defects which was sealed by bone wax successfully. Eleven patients underwent anterior skull base surgery for lesions or aneurysms, with the reconstruction of large FS defects by small supporting bone pieces. During craniotomy, mild violations of the FS mucosa were spared and sterilized, while severe violations required mucosal removal. Small supporting bone pieces were obtained from the inner plate of the bone flap and carefully covered or inserted into the large defects. The large defects were transformed into some small ones, which could be sealed effectively by bone wax. Demographic, intraoperative, and postoperative complication data were collected. Four patients had severe mucosal violations requiring removal, while 7 had mild violations sparing the mucosa. All underwent effective reconstruction with small supporting bone pieces. Median follow-up was 6 months. All cases showed effective FS morphology reconstruction, with no FS-related complications. Applying the small supporting bone pieces for large FS defect reconstruction can restore the FS morphology, preserve physiological function, and avoid postoperative complications. [ABSTRACT FROM AUTHOR]

According to medical literature, the frontal recess' intricate physical structure resembles an inverted funnel. The anatomical structure is not distant from the frontal ostium. Surgery requires a good understanding of the frontal recess architecture because of the intricate anatomy of this relatively small area. The pathophysiological characteristics of frontal sinusitis and the process of sinus ventilation through the sinus ostium have been linked, according to medical literature. Medical studies show that one of the most important factors affecting the amount of drainage in the frontal sinuses is the size of the frontal sinus ostium. Inflammation brought on by frontal recess cells can frequently affect the airflow in the frontal sinuses. The drainage channel of the frontal sinus is stated as narrowing in the current investigation as an observed phenomenon. The aim of this study was to examine the frontal recess changes and how they might affect the emergence of frontal sinusitis. The classification of frontal recesses according to their various categories was the study's principal finding. The investigation of the causal elements that resulted in the development of frontal sinusitis was the study's secondary goal. In a hospital setting, a cohort of 200 patients with sinonasal disorders underwent a retrospective observational research. Over the course of a year, from July 2021 to June 2022, the study participants had evaluations at a tertiary care center. 200 CT PNS images of individuals who fit certain inclusion and exclusion criteria were examined in this study. Using the chi-square test, the study looked into the relationships between several risk factors, including age, gender, and the type of frontal recess. The presence of frontal sinusitis served as the main outcome indicator. This study included a total of 200 participants with a mean age was 43.38 years (± 10.69). There was 146 (73%) male and 54 (27%) female were in the study. Type I frontal recess in 50 (25%), type II in 82 (41%), type III in 24 (12%) and type IV in 18 (9%) patients. The association of age (P = 0.141) and gender (P = 0.345) with frontal sinusitis was not significant. The statistical association between type of frontal recess and frontal sinusitis was statistically not significant. The association between age and the type of frontal recess was found to be statistically significant by Fischer's exact test with P value of 0.012 (< 0.05), whereas gender was not associated with the type of frontal recess by the same test. It is difficult to overstate the significance of the terms frontal recess, frontal sinusitis, and sinus ostium in this particular medical context. This article was a retrospective observational study that investigates the connection between frontal sinusitis and changes in the frontal recess in patients receiving care at tertiary medical facilities. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate that complicated mucoceles of paranasal sinuses and their clinical presentation, complications of relations with size, destructions areas, extension limits in affected patients. Materials and methods: A retrospective review was performed on patients who were diagnosed and treated as paranasal sinus mucoceles at ENT department from 2002 to 2013 years. Patients' demographic data, mucoceles location, symptoms, surgical approach and complications were evaluated. Results: The study group included 9 male and 10 female patients with a mean age of 45,0 years (range, 12–76 years). This case series include fronto-ethmoidal complex (52,6%), followed by frontal (26,3%), maxillary (15,7%) and sphenoid sinus mucoceles (5,2%). Endoscopic sinus surgery (ESS) was performed on 11 patients (57.8%); endoscopic procedures included marsupialization through an infundibulotomy, associated with an anterior ethmoidectomy and maxillary sinus antrostomy. Four patients (21%) underwent an external surgical procedure. 8 patients (42%) were treated by a combination of both endoscopic and external approaches such as trephination of the anterior wall of the frontal sinus, osteoplastic flap approach, Caldwell-Luc operation, anterior craniotomy and Lynch procedure. Complications occurred only in 2 cases (10.5%). Conclusion: The majority of patients with extensive paranasal sinus mucoceles exhibited ophthalmologic and intracranial symptoms. A satisfactory outcome can be achieved after surgical treatment of both endoscopic and external approaches. [ABSTRACT FROM AUTHOR]

A 76-year-old woman, initially thought to have a simple abscess on her right upper eyelid, presented to our department of plastic and reconstructive surgery. Enhanced three-dimensional facial computed tomography (CT) revealed an abscess on the right upper lid, with a pyomucocele present in the right frontal sinus, accompanied by bone erosion in the superior wall of the right orbit. Based on the results of the CT scan, we diagnosed an atypical Pott's puffy tumor (PPT) with an abscess on the upper lid originating from the frontal sinusitis. First, surgical incision and drainage were performed in our department, and a percutaneous vacuum drain was placed. To provide a more definitive treatment, endoscopic sinus surgery (ESS) was subsequently performed by otorhinolaryngologists. The patient was discharged without any complications 5 days after ESS. At a 1-year follow-up, no recurrence or notable neurological symptoms were observed. In the case we observed, the patient presented with an upper eyelid abscess and cellulitis, indicating possible orbital involvement. For such patients, a CT scan is necessary. Given the possibility of PPT, it is critical to perform a comprehensive differential diagnosis rather than defaulting to a straightforward approach involving abscess treatment. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare closed percutaneous screw reduction to traditional open reduction-internal fixation (OR-IF) for the treatment of anterior table fractures. Both groups were evaluated in terms of operative variables, complications, and treatment success. Of 32 patients included, 19 patients underwent OR-IF, while 13 underwent percutaneous screw reduction. The median operative time, length of hospital stays, and treatment cost of the OR-IF group were 100 min (range 60-130), 4 days (range 3-9), and $727 (range $642-$1291), respectively. The same variables for the closed reduction group were 30 min (range 20-40), 2 days (range 1-2), and $303 (range $252-$349), respectively. The closed reduction group exhibited a shorter operative time (p< 0.001), reduced length of hospital stays (p< 0.001), lower treatment cost (p< 0.001), and a lower complication rate (p = 0.025) compared to the OR-IF group. Late-term outcomes in both groups showed no visible contour changes or step deformities. In conclusion, the percutaneous screw reduction technique is a safe and effective option with minimal morbidity in the treatment of frontal sinus anterior table fractures. Therefore, traditional OR-IF should be reserved for fractures that are not suitable for reduction using minimally invasive techniques. [ABSTRACT FROM AUTHOR]

Conventional coronal CT scans of paranasal sinuses, aligned perpendicularly to the nasal floor, often deviate significantly from the endoscopic view during sinus surgery. This discrepancy complicates the interpretation of anatomical structures. In response, we propose the utilization of anteriorly tilted coronal CT slices to enhance anatomical understanding. These slices align more closely with the endoscopic view, fostering an intuitive grasp of paranasal sinus anatomy. This study aims to quantify the tilt of the endoscope to the nasal floor during endoscopic sinus surgery. To figure out the tilt of the endoscopically true coronal slices, we calculated the tilt of the endoscope to the nasal floor in the operative setting by taking pictures of the operation and measuring the image and sagittal CT. Fourteen patients (25 sides of paranasal sinuses) were analyzed. Endoscope tilts to the nasal floor were measured at different anatomical landmarks: 16.2 ± 9.7 degrees (lower edge of ground lamella), 29.8 ± 7.9 degrees (central ground lamella), 62.3 ± 10.1 degrees (most superior part), and 25.6 ± 7.0 degrees (optic canal). In conclusion, we showed the actual tilt of the endoscope to the nasal floor during endoscopic sinus surgery. A 30-degree anteriorly tilted coronal scan for frontal recess and sphenoid sinus is more intuitive than a traditional coronal scan, which helps surgeons understand the complex sinus anatomy. [ABSTRACT FROM AUTHOR]

Objectives: This study is performed to compare the paranasal sinus volumes in paediatric unilateral cleft palate (UCP) and healthy patients. Methods: Cone-beam computed tomography (CBCT) images of 80 patients (40 boys, 40 girls) with UCP and 80 healthy individuals (40 boys, 40 girls) were evaluated. Paranasal sinus volumes were segmented and measured using ITK-SNAP software. Descriptive statistics, Kolmogorov-Smirnov, paired sample t-test and student t-test were performed for statistical analysis. Results: The volumes of ethmoid, frontal and sphenoid sinus on the cleft side were not significantly different than the non-cleft side (p>0.05) in UCP patients. Maxillary sinus volume of the cleft side in UCP patients was significantly lower than the non-cleft side (p<0.05). Mean maxillary sinus volume in UCP patients was 11825.23±509.95 mm3 at the cleft side and 13497.85±358.07 mm3 at the non-cleft side. While the mean volumes of ethmoid and sphenoid sinuses of patients with UCP were not significantly different from healthy individuals (p>0.05), the mean volumes of maxillary and frontal sinuses were significantly lower than healthy individuals (p<0.05). The mean maxillary sinus volume in UCP patients was 25323±597.8 mm3 and 26666±874.3 mm3 in the control group. The mean frontal sinus volume in UCP patients was 5633±323.1 mm3 and 5735±315.2 mm3 in the control group. Conclusions: UCP caused a significant reduction in maxillary and frontal sinus volumes. The results of the current study show that paranasal sinus volumes in patients with UCP should be examined in more detail to make more risk-free and effective treatment plans. [ABSTRACT FROM AUTHOR]

Introduction: The frontal sinus is a well-preserved structure, hence making it a potential site of choice during forensic identification. The coexistence of 2-dimensional (2D) and 3-dimensional (3D) models from imaging has gained interest for forensic usage. Despite the existing comparison between 2D and 3D models, the comparison using frontal sinus within the same patient is yet to be explored. This upsurges a key question on the morphological consistency of 3D over 2D models on the frontal sinus. This pilot study compares the consistency of frontal sinus morphology between 2D and 3D frontal sinus reconstructed models. Methods: The samples comprised 30 digital skull radiographs and CT scans of the same subject. The 3D models of the frontal sinus were reconstructed from CT scans. The 2D and 3D models were superimposed, and the congruence of the morphological features was assessed in a superimposed state using a mix and wipe method. Results: The superimposed frontal sinus morphology on the 2D and 3D models shows a perfect match of 100% in the posteroanterior view. In the lateral view, 77% of the samples failed to match. Conclusion: The 3D frontal sinus model is more recommended to evaluate the frontal sinus region compared to the 2D model. [ABSTRACT FROM AUTHOR]

Summary: This case report describes septic suturitis as a likely cause of periapical dental disease in a 3‐year‐old Thoroughbred colt. The horse was presented for a unilateral sinusitis initially managed by a frontal osteotomy and sinus lavage and subsequently developed a septic suturitis. Subsequently, a computed tomography (CT) examination identified a periapical infection of cheek tooth 109 with associated sinusitis of the rostral sinus compartments and an extensive suturitis, with the most severe changes located at the right nasomaxillary suture line. There was an associated local fistulous tract rostral to the mesial periapical region of cheek tooth 107 but unassociated with typical periapical or endodontic dental disease changes on CT. The sinusitis did not respond to oral extraction of cheek tooth 109 and sinus lavage. A repeat head CT 2 weeks later, now revealed buccal alveolar bone loss surrounding cheek tooth 107 with obvious periodontal and endodontic dental disease changes. Oral extraction of cheek tooth 107 was performed and local curettage of the fistulous tract was conducted. We conclude that septic suturitis can become extensive and slow to resolve and its rostral extension can cause periapical infection of the closely associated rostral cheek teeth in young horses. [ABSTRACT FROM AUTHOR]

Objective: To explore the effects of Draf1–3 on frontal sinus airflow and frontal sinus irrigation in people with different frontal sinus development Methods: The development of the frontal sinus and the distribution of the frontal recess cells were evaluated by CT scan in 150 adults (300 sides). The airflow changes into the frontal sinus and frontal recess after Draf were analyzed by Fluent software under a steady state and quiet inspiratory state. Nasal irrigation after Draf in adults with well-developed frontal sinus was simulated using 120 mL saline at a rate of 12 mL/s in a position at 45° to observe the changes in transient flow distribution. Results: The moderately developed type of the frontal sinus was the most common. The airflow patterns in the frontal sinus and frontal recess in the moderate development group were laminar, while several large vortexes were formed between the frontal sinus and frontal recess in the well-development group. The Draf exerted more significant effects on the patterns, pressure, and velocity of the airflow in the frontal sinus and frontal recess in the well development group than in the moderate development group. The volume fraction of saline in the frontal sinus increased significantly from Draf1 to Draf3, and the time required for a complete infiltration of saline in the frontal sinus mucosa was significantly reduced. Conclusions: Draf1–3 has different effects on the airflow field of the frontal sinus with different developmental types; and Draf1–3 can significantly improve the postoperative flushing of the frontal sinus. [ABSTRACT FROM AUTHOR]

To evaluate differences in the morphology of the frontal sinus in adolescents and adults with different craniofacial patterns, searches up to April 2024 were conducted in six databases and other information sources to identify observational studies. Study selection, data extraction, and quality assessment using the NOS scale were performed independently by two reviewers. Random effects meta-analyses were conducted to estimate the difference in frontal sinus measurements between different craniofacial skeletal patterns (α = 0.05). The certainty of the evidence was evaluated according to GRADE. Fourteen studies were included in the review. All studies had methodological limitations that affected their quality. The syntheses showed that skeletal Class II subjects presented a significantly smaller width of the frontal sinus than skeletal Class I subjects (MD = 0.56; 95% CI: 0.38, 0.74; p < 0.0001; I2 = 3%). Skeletal Class III subjects showed a frontal sinus width (MD = −0.91; 95% CI: −1.35, −0.47; p < 0.0001; I2 = 36%) and area (MD = −28.13; 95% CI: −49.03, −7.23; p = 0.0084; I2 = 66%) significantly larger than those of the skeletal Class I subjects. The available evidence suggests a positive relationship between mandibular and frontal sinus size. There is limited evidence to make reliable estimates of the association of other craniofacial patterns and frontal sinus characteristics. These reported results are not conclusive and should be evaluated carefully due to the very low certainty of the evidence. The current evidence is scarce and consists of studies with methodological limitations; the results of the studies are often inconsistent, and the pooled estimates are imprecise. New high-quality research is still necessary. [ABSTRACT FROM AUTHOR]

Objectives: To document frontal sinus volume (FSV) in a sample of sub‐Saharan Africans with a view to evaluating claims that such populations exhibit comparatively small sinuses. This study also addresses questions related to sexual dimorphism, incidence of sinus aplasia, and the possibility that FSV continues to increase through adulthood. Materials and methods: FSV was measured from CT scans of adult crania from the Dart Collection. Sex and age were known for each individual. Linear cranial dimensions were used to compute a geometric mean from which a scaled FSV was computed for each cranium. Results: FSV does not differ significantly between sexes, but females exhibit a higher incidence of aplasia. There is considerable variation in FSV in this sample, with the average ranking among the higher means reported for other population samples. The incidence of FS aplasia falls within the range of values recorded for other population samples. Although our study is cross‐sectional rather than longitudinal, there is strong evidence that FSV continues to increase with age throughout adulthood. Discussion: The FSV mean of our sample contradicts the notion that sub‐Saharan Africans possess small sinuses. In a global context, geography (climate and altitude) does not appear to be related to FSV. The absence of sexual dimorphism in our sample is unexpected, as significant dimorphism has been reported for most other population samples. Our results support other indications that the frontal sinus continues to expand throughout adulthood, especially in females, and that it is likely due to bone resorption. Research Highlights: Frontal sinus volume in black South Africans is comparable to that in samples from other geographic regions.Frontal sinus volume is not sexually dimorphic among South Africans.The frontal sinus continues to expand throughout adulthood in this sample. [ABSTRACT FROM AUTHOR]

Morphological analysis of the frontal sinuses (FS) is one of the methods used to assess the sex of human remains. Depending on the methods, the results indicate the effectiveness of using the FS in the assessment of sex at the level of 60-85.9%. Our goal was to determine whether the morphological and morphometric methods of sex assessment based on the FS can be used for examining historical populations in anthropological studies. We assessed FS both morphologically and morphometrically on a sample of 76 dry skulls (41 females and 35 males) from 17th-18th century form Poland to evaluate the potential of applying this method for sex estimation in human remains. A total of 76 X-rays were taken in both frontal and lateral views. The morphology and morphometry of the FS were assessed with ImageJ software. There were no significant differences between the sexes in assessing the outline of the upper border of the FS, as well as the number of partial septa. There was a statistically significant difference between the sexes in the width of the right FS, the height of the right and left FS, and the right and left area of the FS. The lateral view indicated a statistically significant difference between the sexes regarding the depth and area of the FS. The accuracy rate in classifying males and females using FS morphometry ranged from 59.09% to 69.57%. The FS in the lateral view (69.57%) and the height of the left FS in the frontal view (68.18%) are the most appropriate regressors for sex determination. Statistically significant differences in some FS measurements between the sexes do not appear to be a sufficient indicator of sex. Morphological and morphometrical characteristics of the FS should not be used as a guideline for sex assessment in the historical Polish population. [ABSTRACT FROM AUTHOR]

Background: The endoscopic modified Lothrop procedure (EMLP) has become a frequently utilized procedure in rhinologic surgery. One of the most serious complications of the procedure is cerebrospinal fluid leak, which may occur due to lack of recognition of the anterior skull base in the region of the first olfactory filum (FOF), or direct injury to the FOF itself. Objectives: To evaluate the position of the head of the middle turbinate (MT) relative to the FOF, which is an important landmark in the EMLP. Methods: A series of previously obtained patient computed tomography scans of the sinus were reviewed. A reproducible process was implemented to obtain the measurements. First, the FOF was identified on an axial series. Using a localization feature of the radiographic software, this anteroposterior (AP) position could be visualized in a coronal plane. Subsequently, the MT was viewed in a sagittal plane, where a measurement between the head of the MT and the AP position of the FOF could be performed. Results: The AP distance between the head of the MT and the FOF was measured in 92 patients. The head of the MT was either at or anterior to the FOF in all measured subjects. The mean anterior distance of the head of the MT to FOF was 3.6 mm (±2.4 mm) on the right, and 3.8 mm (±2.2 mm) on the left. The range in AP distance was 0 to 12 mm. There was no significant difference in AP distance between the head of the MT and FOF based on gender (P =.413) or diagnosis (P =.254). Conclusions: In our study, the head of the MT was reliably at or anterior to the FOF in all subjects, suggesting its utility as a fixed landmark in endoscopic sinus surgery, particularly in the EMLP. Level of Evidence: N/A. [ABSTRACT FROM AUTHOR]

The frontal sinus medial drainage —Draf Type III (modified endoscopic Lothrop) procedure, has become a cornerstone in frontal sinus surgery over the last three decades. Despite its widespread acceptance, challenges such as restenosis and neo-ostium closure persist, prompting the exploration of various preventive techniques. In this retrospective study, we analyzed data from 111 patients who underwent the Draf III procedure between November 2015 and November 2023, with a mean follow-up period of 3 years and 11 months. Approximately two-thirds of patients (64%) had undergone previous sinus surgery and 16% a previous Draf III. Over half of the patients had inflammatory conditions, with the majority being chronic rhinosinusitis with nasal polyps (CRSwNP) (46%), while 15% were diagnosed with malignant sinonasal tumors, and 23% with benign sinonasal tumors, of which the commonest was osteoma, accounting for 14 cases. The mean follow-up period was 3 years and 11 months. We focused on evaluating the efficacy of mucosal flaps and free grafts in preventing neo-ostium closure. Although it appears that there is no statistically significant correlation between flap usage and the need for revision surgery or ostium patency maintenance overall, subgroup analysis highlighted the benefits of flap reconstruction in patients with chronic rhinosinusitis with nasal polyps. In this subgroup, the use of flaps or grafts reduced the rate of neo-ostium stenosis from 20% to 0% (p < 0.05). Overall revision rate was 11.7%—however this was 8% in patients without acute inflammation at the time of surgery and went up to 31% in the presence of pus in the frontal recess (p = 0.02). This study contributes to the existing literature by providing insights into long-term outcomes, the enduring effectiveness of interventions in frontal sinus surgery, and especially the importance of taking into account the underlying pathology when assessing long-term outcomes. [ABSTRACT FROM AUTHOR]

Inverted papilloma is a tumor found involving the nasal cavity and paranasal sinuses. They are not cancerous but can be locally aggressive. They are most commonly seen involving the lateral wall of nose and maxillary sinus. When the tumor involves the frontal sinus and sphenoid sinus or the post ethmoid cells it presents a surgical challenge. Inverted papilloma almost always occur unilateraly and affect mainly the maxillary sinus. Inverted papilloma arising from the sphenoid and frontal sinuses are rare. Here we present two cases; one involving a 60 year man, with inverted papilloma originating from the frontal sinus and another case where it originated from the sphenoid sinus anterior wall and posterior ethmoidalcell (Onodi cell) and was resected endoscopically. [ABSTRACT FROM AUTHOR]

Objectives The bacteriological features of the frontal sinus mucosa may impose significant complications in neurosurgery, when breached unintentionally. This study aimed to investigate the bacterial flora in patients undergoing frontal craniotomy for cerebrovascular substrate surgery. Design This is a single-center prospective study. Setting When mucosal laceration occurred, the patients underwent frontal sinus reconstruction with mucosa reconstruction, preserving the nasofrontal duct. Participants We enrolled eight consecutive patients who underwent bifrontal craniotomy associated with frontal sinus mucosa laceration. Main Outcome Measures A portion of the mucosa was extracted during the reconstructive procedure and was sent for microbiological analysis. Results None of the patients presented with the bacterial flora in the mucosal cultures. No patient experienced postoperative cerebrospinal fluid leakage or meningitis. One patient with a clinical history of chronic maxillary sinusitis presented with a subcutaneous abscess around the forehead at 9 months postoperatively. The patient rapidly recovered after receiving oral administration of antibiotics. Conclusions Our findings demonstrated that the frontal sinuses were maintained in an aseptic environment in all cases. The results may encourage the development and wider use of transfrontal sinus approaches. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Osteoblastoma of the frontal sinus, although rare, can manifest with seizures and pneumocephalus, underscoring the importance of thorough evaluation and complete surgical excision to prevent serious complications and ensure optimal patient outcomes. Osteoblastoma is an infrequent bone tumor, with origins typically in the vertebrae and long bones. While craniofacial involvement is rare, it may occur in regions such as the paranasal sinuses. We present a case of osteoblastoma located in the frontal sinus, an exceptionally uncommon site, resulting in seizures secondary to pneumocephalus. A 21‐year‐old male presented with a generalized tonic–clonic seizure and postictal confusion. Imaging studies revealed a well‐defined lesion in the left frontal sinus causing cortical breach, destruction of the posterior wall, and pneumocephalus. A total surgical excision was performed through bifrontal craniotomy. Histopathological analysis confirmed the diagnosis of osteoblastoma. Postoperative recovery was uneventful, with a follow‐up CT scan showing complete lesion excision. Osteoblastomas, especially in the cranial sinuses, are rare entities that may present asymptomatically but can lead to severe complications. The risk of recurrence underscores the importance of complete surgical resection for optimal patient outcomes. [ABSTRACT FROM AUTHOR]

In this study using computed tomography (CT), the volumes of the internal cranial cavities, such as the braincase, frontal sinus and tympanic cavity, and the ratio of the volume of each cavity to the skull volume in Japanese wolves were quantified, and CT images of the frontal sinus were observed. The results were then compared with those of other wolf subspecies, including Akita, a dog breed, to clarify the characteristics of the internal cranial cavities in Japanese wolves. The present study revealed that the Japanese wolf had a relatively larger braincase volume and a relatively smaller frontal sinus volume than the wolf ssp. (a group of wild wolf subspecies except the Japanese wolf) and Akita. Moreover, the relative and absolute tympanic cavity volumes of the Japanese wolf and Akita were significantly smaller than those of the wolf ssp. In the CT image or macroscopic observations, the frontal sinuses of the wolf ssp. and Akita were relatively well developed to the caudal and dorsal directions, respectively, compared with that of the Japanese wolf, and the tympanic cavity of the wolf ssp. was more largely swelled ventrally and medially than that of other groups. [ABSTRACT FROM AUTHOR]

Purpose: Aiming to evaluate and study the epidemiological profile of frontal sinus fractures treated in the region of Ribeirão Preto—Brazil, Methods: Sixteen years of activity in the Oral and Maxillofacial service of the Faculty of Dentistry of Ribeirão Preto/SP (FORP/USP), totaling 9,736 consultations, 4,524 with facial fractures, those diagnosed with frontal sinus fracture (113) were evaluated and selected for the study. Results: Frontal sinus fractures accounted for 2.5% of facial fractures, the majority occurring in men (89.4%), concentrated in the age group 21–30 years old, with 52.2% of cases being caused by road traffic accidents (RTA). Associations with other facial fractures are common and appeared in 75.2% of cases. Treatment was followed either surgically, by open reduction internal fixation (52.2%) or conservatively (35.4%). Analyzing only the 28 isolated frontal sinus fractures, the most common treatment was conservative (46.4%). surgical treatment dropped to 25%. The most common postoperative complications were temporal branch paralysis and supraorbital nerve paresthesia, both occurring in 30.5% of surgical cases. Conclusion: The frequency of frontal sinus fractures may be decreasing, but the pattern of occurrence in young men due to road traffic accidents does not seem to change, fortunately the appearance of serious complications is not common and it is usually associated with more severe trauma. [ABSTRACT FROM AUTHOR]

Key Points The optimal tilt for anteriorly tilted coronal CT was examined. A 30° anteriorly tilted coronal CT best visualized the frontal sinus drainage pathway. [ABSTRACT FROM AUTHOR]