The International Frontal Sinus Anatomy Classification (IFAC) and Classification of the Extent of Endoscopic Frontal Sinus Surgery (EFSS)

Peter-John Wormald; Werner Hoseman; Claudio Callejas; Rainer K Weber; David W Kennedy; Martin J Citardi; Brent A Senior; Timothy L Smith; Peter H Hwang; Richard R Orlandi; Oliver Kaschke; Jin Keat Siow; Kornel Szczygielski; Ulrich Goessler; Martin Khan; Manuel Bernal-Sprekelsen; Thomas Kuehnel; Alkis Psaltis

doi:10.1002/alr.21738

The International Frontal Sinus Anatomy Classification (IFAC) and Classification of the Extent of Endoscopic Frontal Sinus Surgery (EFSS)

Int Forum Allergy Rhinol. 2016 Jul;6(7):677-96. doi: 10.1002/alr.21738. Epub 2016 Mar 14.

Authors

Peter-John Wormald¹, Werner Hoseman², Claudio Callejas³, Rainer K Weber⁴, David W Kennedy⁵, Martin J Citardi⁶, Brent A Senior⁷, Timothy L Smith⁸, Peter H Hwang⁹, Richard R Orlandi¹⁰, Oliver Kaschke¹¹, Jin Keat Siow¹², Kornel Szczygielski¹³, Ulrich Goessler¹⁴, Martin Khan¹⁵, Manuel Bernal-Sprekelsen¹⁶, Thomas Kuehnel¹⁷, Alkis Psaltis¹

Affiliations

¹ Department of Surgery-Otolaryngology, University of Adelaide, Adelaide, Australia.
² Department of Otorhinolaryngology-Head and Neck Surgery, University of Greifswald, Greifswald, Germany.
³ Otorhinolaryngology Department, Pontificia Universidad Católica de Chile, Santiago, Chile.
⁴ Division of Sinus and Skull Base Surgery, Department of Otorhinolaryngology Hospital, Karlsruhe, Germany.
⁵ Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA.
⁶ Department of Otorhinolaryngology-Head and Neck Surgery, University of Texas Medical School at Houston, Houston, TX.
⁷ Division of Rhinology, Allergy, and Endoscopic Skull Base Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC.
⁸ Division of Rhinology and Sinus/Skull Base Surgery, Oregon Health and Science University, Portland, OR.
⁹ Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA.
¹⁰ Division of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, UT.
¹¹ Department of ENT, Sankt Gertrauden Krankenhaus, Berlin, Germany.
¹² Department of Otolaryngology, Tan Tock Seng Hospital National University of Singapore, Singapore.
¹³ Department of Otolaryngology, Military Institute of Medicine, Warsaw, Poland.
¹⁴ Department of Otolaryngology-Head and Neck Surgery, University of Mannheim, Frankfurt, Germany.
¹⁵ HNO-Klinik, Klinikum Dahme-Spreewald GmbH, Königs-Wusterhausen, Germany.
¹⁶ University of Barcelona Medical School, Barcelona, Spain.
¹⁷ ORL-Dept, Head and Neck Surgery, University of Regensburg, Germany.

PMID: 26991922
DOI: 10.1002/alr.21738

Abstract

The frontal recess and frontal sinus anatomy can vary from simple to complex. The variations in the anatomy of the frontal recess and frontal sinus are considerable but almost all variations can be classified if the various cell patterns are analyzed. This consensus document was developed to improve the ability of the surgeon to understand these possible variations, plan the surgery, and communicate these complexities when teaching or reporting outcomes. Once the surgeon understands the anatomical pattern of the frontal sinus and recess cells, the extent of surgery can be planned. This document presents a classification of the extent of surgery based on the anatomical classification.

Keywords: EFSS; IFAC; frontal sinusotomy; radiology; sinus anatomy; sinus surgery.

MeSH terms

Endoscopy / classification*
Frontal Sinus / anatomy & histology
Frontal Sinus / diagnostic imaging
Frontal Sinus / surgery*
Humans
Tomography, X-Ray Computed