Patterns of Distribution of Frontal Recess Cells and Superior Attachment of Uncinate Process in Patients Undergoing Paranasal Computed Tomography Scan at the Kenyatta National Hospital

Abstract

Background Frontal recess cells and superior attachment of uncinate process are key to understanding the drainage of frontal sinus and are important anatomical landmarks during endoscopic sinus surgery. The two have variable anatomical distribution patterns among individuals and are best assessed using a high-resolution computed tomography scan of the nose and paranasal sinus. Objective To determine the patterns of distribution of frontal recess cells and superior attachment of uncinate process in patients undergoing paranasal sinuses computed tomographic scan at Kenyatta National Hospital. Study population: The study involved adult patients 18 years and above undergoing paranasal sinus region imaging. Study design: This was a descriptive cross-sectional study Study Setting: The study was conducted at Kenyatta National Hospital Ear, Nose and Throat and Radiology departments. Methodology A total of 100 patients undergoing nose and paranasal sinus region CT scan were recruited via convenient sampling method and informed consent obtained. Multiplanar reconstruction CT scan images were obtained and reviewed with a consultant radiologist. The patterns of frontal recess cells and superior attachment of uncinate process was documented. Results One hundred CT scans (200 sides) were examined. The mean age was 42years with male: female ratio of 13:7. Out of the 200 sides, 83.5% had an Agger Nasi cell, 16.0% had a Supra Agger Nasi cell, 1.0% had a Supra Agger Frontal cell, 63.0% had a Supra Bulla cell, 6.5% had a Supra Bulla Frontal cell, 1.0% had a Supraorbital Ethmoid cell, and 2.0% had a Frontal Septal cell. In terms of the distribution of superior attachment of the uncinate process type I 44%, type II 6.5%, type III 5%, type IV 5%, type V 17% and type VI 22.5%. viii Conclusion Agger Nasi cell and type I attachment were the most prevalent frontal recess cell and uncinate superior attachment pattern in this population.