Frontal Sinus Morphometry in Relation to Surgically Relevant Landmarks in the Middle East Population: Can We Globalize?

BACKGROUND: The frontal bone is frequently approached during neurosurgical procedures. Feared complications of such surgeries include cerebrospinal fluid leak, among others, and frequently result from a breach of the frontal sinus. For this reason, the sinus should be avoided when possible. The supraorbital notch (SON) is a reliable and easily identifiable surgical landmark and its relation to the frontal sinus has been previously studied. However, the frontal sinus shows significant variability in size and shape between populations.METHODS: In the present study, we investigate the frontal sinus dimension and its relation to the SON in the Middle Eastern population.RESULTS: The analysis of a set of computed tomography scans reveals a significant variation in size between genders, and we subsequently provide neurosurgeons in the region with population-targeted, gender-specific risk maps.CONCLUSIONS: We finally conclude that a 2-cm margin rostral and lateral to the SON is safest.