The dissertation is dedicated to studying the structural variations and topography of the frontal sinus in individuals of mature age of different genders and clarifying their age-related features.
Nasal and paranasal sinus diseases currently occupy leading positions in the general structure of ENT pathology and have a stable tendency to increase. In the structure of outpatient visits, acute sinusitis accounts for 40-60%, and their frequency increases by 1.5-2% annually. Acute and chronic inflammation of the paranasal sinuses is diagnosed in 15-20% of the population, while in almost 30% of patients, pathology from various reasons is not detected in a timely manner. These trends are determined by numerous factors such as environmental conditions, the increase in the number of respiratory viral and bacterial infections, allergic reactions, and the decrease in local and general immunity. However, according to various authors, one of the key factors determining the frequency of manifestation and severity of sinusitis and its complications is the structural and topographical features of the paranasal sinuses. From a morphological point of view, the paranasal sinuses are complex anatomical structures that attract the attention of researchers in both clinical and morphological directions. Numerous studies are dedicated to studying the individual anatomical variability of the paranasal sinuses in humans during different stages of ontogenesis, comparing the structure and development of the human paranasal area with experimental animals, methods of diagnosis, and methods of prevention and treatment of sinusitis of different origins and localization. The frontal sinuses occupy a special place among the paranasal sinuses, particularly due to the pronounced variability of their shape, size, and topography, variants of development, proximity to the cranial cavity, and orbit. Each of these factors is significant in the etiology, pathogenesis, clinical course of frontal sinus diseases, their differential diagnosis, the spread of the process beyond the sinuses, the choice of treatment method, and surgical access. Modern scientific medical literature contains numerous data on the causes of frontal sinusitis, their diagnosis methods, and treatment methods. Many studies are devoted to studying the regularities of age-related restructuring of frontal sinuses, starting from early ontogenetic terms, studying the dynamics of their size, shape, and topography, histotopographic and morphometric data, structural components of their mucous membrane, quantitative and qualitative characteristics of the branch of its hemimicrocirculatory network, glands, epithelium of the mucous membrane, and etc. However, in the vast majority, studies are devoted to individual morphological, and more often - clinical aspects of studying frontal sinuses, primarily those related to the development of certain pathological processes. Only a few studies take a comprehensive approach to the lifelong study of the structure and topography of frontal sinuses, taking into account their age and gender characteristics and using modern highly informative morphological and clinical methods. Such an approach, which involves a deep and thorough knowledge of the radiological and surgical anatomy of the frontal sinus considering its variability, is a necessary condition for successful treatment of pathologies of this area and reducing the risk of complications during surgical interventions and throughout the postoperative period.
During the work, 520 X-ray images and 355 series of head CT scans of mature individuals, who were patients of the "Lithotripsy Center" (Lviv) and the medical center "EXPERT HOSPITAL" (Lviv) and sought medical help exclusively for medical reasons, were processed. Inclusion criteria for patients in the study: individuals without diagnosed pathology of the frontal sinuses, frontal bone, of mature age. Exclusion criteria: head trauma in the frontal region, diagnosed pathology of the frontal sinuses, frontal bone. For further processing, 50 X-rays and 55 series of CT scans were selected. All examined individuals were divided by gender and age into four groups (men: 22-35/36-60 years old; women 22-35/36-55 years old). During the work, were used radiological methods (digital radiography; computed tomography); anthropometric and morphometric research methods, as well as statistical analysis method.
X-rays were performed on the digital mobile X-ray system Fujifilm, FDR Nano DR-DX 1000 MBL E (Japan) manufactured in 2021. The images were taken in the posteroanterior projection by Waters view in the Paranasal sinus, FRN mode.
Computer tomographic examination of patients was carried out on a modern computer tomograph Siemens SOMATOM GO.UP 32 (64) (Germany) manufactured in 2021.
