title: Anatomy, classification of intersinus septal cell and its clinical significance in frontal sinus endoscopic surgery in Chinese subjects.
abstract: BACKGROUND
  Intersinus septal cell (ISSC) is not a very uncommon frontal recess cell. But it is poorly described in literature. The clinical significance of this anatomic variant still remains unclear. The purpose of this study was to clarify the anatomy, classification of ISSC and its clinical significance in Chinese subjects.
  
  
  METHODS
  We prospectively identified ISSC in 200 consecutive subjects who had undergone computed tomography (CT) scans: 120 without frontal sinusitis (group 1) and 80 with frontal sinusitis (group 2). The ISSC was classified into two types: Type I ISSC communicated with frontal sinuses, type II ISSC communicated with frontal recess. The patients of frontal sinusitis had undergone functional endoscopic sinus surgery with the assistance of the classification of ISSC. Statistical analysis was performed to correlate the ISSC and its type to the presence of frontal sinusitis.
  
  
  RESULTS
  The ISSC was obvious when reviewing the coronal and axial CT scans. Of the 200 CT scans reviewed, ISSC were present in 90 (45%). Of the 120 scans in group 1, ISSC were present in 49 (41%), among which type I ISSC was in 22 (18%) and type II was in 27 (23%). Of the 80 scans in group 2, ISSC was present in 41 (51%), among which type I ISSC was in 16 (20%) and type II was in 25 (31%). There were no statistically significant differences about the frequency distribution of total ISSC, type I and II ISSC between group 1 and group 2.
  
  
  CONCLUSIONS
  The prevalence of ISSC was very high in Chinese patients. The classification of ISSC was helpful for surgeon to operate according to whether it communicated with frontal sinus or frontal recess. The type II ISSC could be relatively easily removed from frontal recess.
authors.affiliation: Department of Otolaryngology, Peking University People's Hospital, Beijing, China.
authors.forename: Min
authors.initials: M
authors.lastname: Wang
authors.forename: Fei
authors.initials: F
authors.lastname: Yuan
authors.forename: Wei-wei
authors.initials: WW
authors.lastname: Qi
authors.forename: Jye-yuan
authors.initials: JY
authors.lastname: Cheng
authors.forename: Xiao-pei
authors.initials: XP
authors.lastname: Yuan
authors.forename: Lin
authors.initials: L
authors.lastname: Han
authors.forename: Zhi-min
authors.initials: ZM
authors.lastname: Xing
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005626:Frontal Sinus / Q000033:anatomy & histology* / Q000473:pathology*; D015522:Frontal Sinusitis / Q000145:classification* / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D055815:Young Adult