What is the incidence of frontal sinus septum (FSS) pneumatization in the general population?

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Last updated: June 16, 2025View editorial policy

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From the Research

The incidence of frontal sinus septum (FSS) pneumatization in the general population is approximately 28%, as reported in the most recent study 1. This anatomical variation occurs when air cells develop within the bony septum that divides the right and left frontal sinuses. FSS pneumatization is clinically significant because it can complicate frontal sinus surgery by creating additional compartments that may be difficult to access and drain properly. The condition is typically diagnosed incidentally on CT imaging of the paranasal sinuses. Some key points to consider include:

  • The pneumatization develops during the normal process of frontal sinus formation, which continues through adolescence and early adulthood 2.
  • Surgeons performing endoscopic sinus procedures should be aware of this variation as it may require modification of surgical technique to ensure complete access to all sinus compartments.
  • The presence of FSS pneumatization may also be associated with a higher risk of mucocele formation if drainage pathways become obstructed.
  • A study from 2021 found that septal pneumatizations extended from neighboring air spaces in 73.1% of cases 3.
  • Another study from 2004 described frontal sinus pneumatization in patients with no history of frontal sinus disease, and found a prevalence of interfrontal septal cell of 14% 4. However, the most recent and highest quality study 1 provides the most accurate estimate of the incidence of FSS pneumatization.

References

Research

Incidence of anatomical variations according to the International Frontal Sinus Anatomy Classification (IFAC) and their coincidence with radiological sings of opacification.

European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2019

Research

The sinus septi nasi and other minor pneumatizations of the nasal septum.

Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2021

Research

3D computed tomographic analysis of frontal recess anatomy in patients without frontal sinusitis.

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2004

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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