Frontal sinus septations predict the presence of supraorbital ethmoid cells.

OBJECTIVES/HYPOTHESIS: This study is undertaken to determine if the presence or absence of multiseptated frontal sinuses is associated with the presence or absence of supraorbital ethmoid cells (SOECs). STUDY DESIGN: Analysis of prospectively collected data. METHODS: Sixty consecutive patients with chronic rhinosinusitis were identified from a prospectively collected database at a tertiary-referral institution as having full-sinus computed tomography (CT) scans. Preoperative or initial CT scans of the sinuses were reviewed, specifically identifying the presence or absence of supraorbital ethmoid air cells (SOECS) and frontal sinus multiseptated sections on coronal imaging. Statistical analysis was performed using the chi-squared test to evaluate any association between the two structural entities. RESULTS: Sixty total patients were identified, for a total of 120 sides. Of the 61 sides with frontal septations, 43 (70%) had SOECs present and 18 (30%) did not. Of the 59 sides without frontal sinus septations, 13 (22%) had SOECs present and 46 (78%) did not (chi squared = 28.3; P = 0.0000001). The difference in the presence of supraorbital ethmoid cells between whites and blacks is also statistically significant (chi squared = 4.23; P = 0.040). CONCLUSION: The presence of frontal sinus septations appears to be significantly associated with and predictive of the presence of supraorbital ethmoid cells. Thus, identifying frontal sinus septations on sinus CT is implicated with more complex anatomy of the frontal recess.

The association between supraorbital ethmoid air cells and orbital proptosis in patients with chronic rhinosinusitis.

BACKGROUND: Orbital proptosis is a known possible complication in patients with chronic rhinosinusitis (CRS). This study was undertaken to determine the association of sinus anatomy and anatomic variants with the predisposition for such a complication. METHODS: All adult patients (n = 16) with orbital proptosis were identified from a prospectively-collected database at a tertiary institution. These were compared with a series of randomly-selected patients (n = 50) diagnosed with chronic sinusitis and who had undergone sinus computed tomography. The presence or absence of supraorbital ethmoid air cells (SOECs) was noted and compared between the 2 groups. The primary sinus anatomy responsible for the proptosis was also identified. Statistical analysis was performed using the chi squared test. RESULTS: Sixteen patients with orbital proptosis were identified, of which all but 1 had SOECs present. Causal analysis showed that in all but 1 case the SOECs were the cause of proptosis. Of the 50 patients with CRS but without proptosis, only 13 had SOECs present and 37 patients did not (chi squared = 22.8, p = 0.000002). CONCLUSION: SOECs appear to be highly associated with and most often are responsible for orbital proptosis in patients with CRS.