3D CT stereoscopic imaging: observations of the frontal and anterior ethmoid sinuses development from birth to early adulthood

Objective: Our objective is to provide observations demonstrated with 3Dimensional Computed x-ray Stereoscopic Imaging (3DCTSI) in the evaluation of the anterior ethmoid and frontal sinus development from birth to age 18. Methods: This is a retrospective evaluation of patient’s CT studies performed over a fifteen-year period, reported as normal studies, and included 53 patients (142 sides) from birth to age 18. Results: At birth, there are two spaces covered by folds, the uncinate and bulla lamellae. The spaces communicate with the Middle Meatus (MM) through the emerging ethmoid infundibulum (EI) and the retrobulbar recess space (RBRS). In the first month after birth, an expansile and breakdown developmental phase blend and continue throughout the growth into the teenage years. The 3D images reveal dark lamellar structures, on the surface of the medial lamina papyracea as well as bridging the broken spatial outlines. The dark lamellae represent the mucosal lamina propria, in unossified lamellae and are the origin of permanent spatial walls. From ages 4 to 18 years, initially, the frontal recess (FR) and later the MM penetrate into the cancellous frontal bone creating the frontal Sinus (FS), the frontal septum (FS), Inter-Frontal Sinus Septal Cell (IFSSC), as well as the Fronto-Ethmoidal and Frontal Bulla Spaces. Conclusion: 3DCTSI is the first intuitive imaging modality to reveal the microanatomical development of the anterior ethmoid and frontal sinus anatomy.