Evaluation of the structure of the walls of the frontal sinus using spiral computed tomography

Abstract

Introduction. The anatomical structure of the frontal sinus is of key importance for development of its inflammation as well as the complications with the spread to the adjacent organs and tissues (orbital phlegmon, brain abscesses, meningitis). The aim of our study was to compare the density and thickness of the bone tissue of the unchanged frontal sinus in various forms of chronic inflammation. Materials and methods. The study involved 121 patients with various forms of chronic frontal sinusitis: 56 with chronic hyperplastic (mucosal hyperplasia (up to 6 mm) and 33 patients with chronic purulent-polypous frontal sinusitis, manifested by a total and subtotal decrease in sinus pneumatization according to spiral computed tomography (SCT). 32 SCT samples were selected to form a comparison group without any abnormalities of the paranasal sinuses. Results. The maximum density typical for the lower wall of the frontal sinus under physiological conditions was found to be 107.96 ± 201.64HU, the minimum for the posterior wall in purulent-polypous frontal sinusitis was -103.74 ± 195.37HU. The bone thickness both in the posterior region and in the region practically did not depend on the degree of the severity of pathological changes in it and was 1.0006 ± 0.538 mm, 0.91 ± 0.26 mm, 0.82 ± 0.169 mm under physiological conditions, with mucosal hyperplasia and with purulent-polypous frontal sinusitis in the posterior wall, respectively. In the region of the lower wall, 4.05 ± 2.04 mm, 2.32 ± 1.16 mm, and 4.002 ± 1.16 mm, respectively. Conclusion. It can be assumed that the larger the change in PNSs, the lower the bone density. This in turn affects the prediction of possible complications during surgical treatment of chronic frontal sinusitis