The prevalence of frontal sinus agenesis (aplasia) among Kurdish populations of Erbil city.


  • Soran M Karim Department of Oral and Maxillofacial Surgery, College of Dentistry, Hawler Medical University, Erbil, Iraq.



Prevalence, Frontal bone, Frontal sinus, Aplasia, Kurdish peoples, Anatomical variations


Background and objective: The frontal bone contains a pair of air-filled hollow cavities called
frontal sinuses, the size, shape and anatomic measurements and dimensions of the frontal sinuses are determined by the degree of its pneumatization. Any disturbance to the sinus during
its early development stages could results whether in hypoplasia (underdevelopment) or aplasia (total lack) of the sinus either unilaterally or bilaterally. This study aims to investigate the
prevalence of aplasia of the frontal sinus among Kurdish populations of Erbil city, in addition to
assessment of the type of aplasia and gender impact on the condition if there is any.
Methods: This retrospective/radiological study was conducted on randomly selected PA
(Caldwell view or occipito-frontal) plain radiographic images of 512 Kurdish individuals of
mixed genders, ages rangeing between 18 to 64 years and images were taken from the periods
between April 2020 to May 2022.
Results: Careful examination of 512 assessed PA radiographs (with patient’s ages ranging between 18 to 65 years) showed agenesis of the frontal sinus in 26 cases (5.16 %), 17 females and
9 male cases), the type and location of the agenesis varied greatly as it was bilateral agenesis
type only in 7 cases, and unilateral in remaining 19 cases, among the unilateral sinus agenesis
cases 2 were observed to be agenesis of the left and 17 of the right frontal sinuses respectively.


Sadler T W. Longmans medical embryology with

clinical correlations; 14th edition, ELSEVIER Ohio,

11; 143-152.

Richard L D, Wayne A V, Adam W M. Grays' medical human anatomy with clinical correlations; 4th

edition, Wiley, Baltimore 2020; 832-837.

Keith L M, Arthur F D, Anne M R. Clinically oriented anatomy by system. 8th edition, WB Publishing inc., NYC. 2017; 963-965.

Laurence E W. Snell's clinical anatomy by region.

th edition, Lippincott & Williams, London,

; 621-623.

Eggesbo HB, Sovik S, Dolvik S, Eiklid K, Kolmannskog F. CT characterization of developmental variations of the paranasal sinuses in cystic

fibrosis. Acta Radiol. 2001; 42(5):482–93.

Hanson CL, Owsley DW. Frontal sinus size in

Eskimo population. A & J Phys Anthropol. 1988;


Spaeth J, Krugelstein U, Schlondorf G. The paranasal sinuses in CT-imaging: development from

birth to age 25. Int J Pediatr Otorhinolaryngol. 1997; 39:25–40.

Sommer F & Hoffmann TK. Incidence of anatomical variations according to the International

Frontal Sinus Anatomy Classification (IFAC). Eur

Arch Otorhinolaryngol 2019; 276: 3139–3146.

Al-Abri R, Bhargava D, Al-Bassam. Clinically significant anatomical variants of the frontal sinus.

W. Oman Med J. 2014; 29:110–113.

Keast A, Yelavich S, Dawes P, Lyons B. Anatomical variations of the paranasal sinuses in Polynesian and New Zealand Europeans computerized tomography scans.. Otolaryngol Head

Neck Surg. 2008;139:216–221.

Kim HJ, Jung Cho M, Lee JW, Tae Kim Y, Kahng

H, Sung Kim H. The relationship between anatomic variations of paranasal sinuses and

chronic sinusitis in children. Acta Otolaryngol. 2006; 26:1067–1072.

Lien CF, Weng HH, Chang YC, Lin YC, Wang

WH. Computed tomographic analysis of

frontal recess anatomy and its effect on the

development of frontal sinusitis. Laryngoscope. 2010;120:2521–2527.

Harris, A. M. P.; Wood, R. E.; Nortje, C. J. &

Thomas, C. J. The frontal sinus: Forensic fingerprint .A pilot study. J. Forensic Odontostomatol., 2005; (1):9-15.

Yazici D. The analysis of computed tomography of paranasal sinuses in nasal septal deviation.. J Craniofac Surg. 2019;30:0.

Cho JH, Park MS, Chung YS, Hong SC, Kwon KH,

Kim JK. Do anatomic variations of the middle

turbinate have an effect on nasal septal deviation or paranasal sinusitis? Ann Otol Rhinol

Laryngol. 2011;120:569–574.

Kaplanoglu H, Kaplanoglu V, Dilli A, Toprak U,

Hekimoğlu B. An analysis of the anatomic variations of the paranasal sinuses and ethmoid

roof using computed tomography. Eurasian J

Med. 2013; 45:115–125.

Aydinlioğlu A, Kavakli A, Erdem S. Absence of

Frontal Sinus in Turkish Indivudials. Yonsei

Med J. 2003; 44(2):215–8.

Pondé JM, Metzger P, Amaral G, Machado M,

Prandini M. Anatomic variations of the frontal

sinus. Minim Invasive Neurosurg. 2003;46


Ozgursoy OB, Comert A, Yorulmaz I, Tekdemir

I, Elhan A, Kucuk B. Hidden unilateral agenesis

of the frontal sinus: human cadaver study of a

potential surgical pitfall. Am J Otolaryngol. 2010;31(4):231–4.

Sheriff RM, Moideen CP. Incidence of frontal

sinus aplasia in Indian population. International Journal of Otorhinolaryngology and Head and Neck Surgery 2017; 3: 108-117.

Çakur B, Sumbullu MA, Durna NB. Aplasia and

agenesis of the frontal sinus in Turkish individuals: a retrospective study using dental volumetric tomography. Int J Med Sci 2011; 8: 278


Alshaikh N, Aldhurais A.Anatomic variations of

the nose and paranasal sinuses in saudi population: computed tomography scan analysis. The KSA Journal of Otolaryngology 2018; 34: 234.

Al-Balas HI, Alomari A, Almehzaa S. Prevalence

of Frontal Sinus Aplasia in Jordanian Individuals. J Craniofac Surg 2020; 31: 2040–2042.

Gotlib T, Kuźmińska M, Held-Ziółkowska M,

Osuch-Wójcikiewicz E, Niemczyk K. Hidden

unilateral aplasia of the frontal sinus: a radioanatomic study. Int Forum Allergy Rhinol. 2011; 5:441–447.




How to Cite

Karim SM. The prevalence of frontal sinus agenesis (aplasia) among Kurdish populations of Erbil city. EDJ [Internet]. 2023 Dec. 22 [cited 2024 Mar. 5];6(2):215-24. Available from:



Original Articles