title: Frontal recess anatomy in Japanese subjects and its effect on the development of frontal sinusitis: computed tomography analysis.
abstract: BACKGROUND
  Comprehensive understanding of frontal recess anatomy is essential for the successful treatment of patients with frontal sinus disease. This study was designed to determine the prevalence of specific frontal recess cells in Japanese subjects and the association of these cells with the development of frontal sinusitis.
  
  
  METHODS
  Frontal recess anatomy was analyzed using high-resolution spiral computed tomography images of paranasal sinuses from December 2008 through September 2011. The distribution of various frontal recess cells in patients with and without frontal sinusitis was compared by logistic regression analysis.
  
  
  RESULTS
  A total of 150 patients met the criteria, and 300 sides were analyzed. Agger nasi cells were present in 88.0 % of sides; frontal cell types 1 (FC1), 2 (FC2), 3 (FC3), and 4 (FC4) were present in 37.0 %, 6.3 %, 4.3 %, and 1.3 %, respectively; supraorbital ethmoid cells in 6.0 %, suprabullar cells in 37.0 %, frontal bullar cells (FBC) in 7.0 %, and interfrontal sinus septal cells in 8.6 %. Multiple logistic regression analysis showed that the presence of FBCs was significantly associated with the development of frontal sinusitis (p = 0.043).
  
  
  CONCLUSIONS
  The frequencies of frontal recess cells in Japanese adult patients were similar to those reported for other East Asian adult populations, including Chinese, Korean, and Taiwanese. Anatomically, FBCs may show a greater association with the development of frontal sinusitis than other frontal recess cells.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Division of Clinical Medical Science, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan. kazunokubota@gmail.com.|Department of Otorhinolaryngology, Hiroshima University School of Medicine, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. kazunokubota@gmail.com.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kubota
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Division of Clinical Medical Science, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan. takeno@hiroshima-u.ac.jp.
authors.forename: Sachio
authors.initials: S
authors.lastname: Takeno
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Division of Clinical Medical Science, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan. katsuhw@hiroshima-u.ac.jp.
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Hirakawa
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D002452:Cell Count; D002908:Chronic Disease; D003431:Cross-Cultural Comparison; D005626:Frontal Sinus / Q000000981:diagnostic imaging*; D015522:Frontal Sinusitis / Q000000981:diagnostic imaging*; D006801:Humans; D008875:Middle Aged; D012016:Reference Values; D012220:Rhinitis / Q000000981:diagnostic imaging; D012307:Risk Factors; D036542:Tomography, Spiral Computed / Q000379:methods*