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. 2020 May;41(5):466-472.
doi: 10.15537/smj.2020.5.25071.

Assessment of International Frontal Sinus Anatomy Classification among senior residents through inter- and intra-rater reliability

Kholood Assiri  1 , Ahmad Alroqi, Turki Aldrees, Sharif Almatrafi
Affiliations

Assessment of International Frontal Sinus Anatomy Classification among senior residents through inter- and intra-rater reliability

Kholood Assiri et al. Saudi Med J. 2020 May.

Abstract

Objectives: To evaluate the International Frontal Sinus Anatomy Classification (IFAC) reliability among Saudi board otorhinolaryngology senior residents.

Methods: This cross-sectional study was carried out at King Abdulaziz University Hospital, Riyadh, Saudi Arabia between April 2019 and December 2019, included 32 senior residents. Questionnaires with 4 computed tomography images showing the different frontal cell types were used in this survey. All scans included 3 planes (axial, sagittal, coronal) and the tested cell was marked with arrows. Residents chose the answer from multiple choices according to the IFAC system. All residents filled the same questionnaire twice with 2 weeks interval.

Results: Approximately 68.8% of residents agreed that the classification was applicable clinically. The resident's attitude toward the importance of understanding IFAC was 65.6%. Residents' correct classification of the marked cells increased significantly for most of the questions from baseline to 2 weeks.

Conclusion: The frontal sinus is not easy to treat surgically, and its inadequate treatment causes the failure of drainage, as in the case of chronic rhinosinusitis. Therefore, surgeons must fully understand the IFAC system to avoid major and minor complications.

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Figures

Appendix 1
Appendix 1
International Frontal Sinus Anatomy Classification.
Figure 1
Figure 1
Computed tomography scan of a single agger nasi cell showing the A) axial plane, B) coronal plane, C) sagittal plane
Figure 2
Figure 2
Computed tomography scan of frontal septal cell showing the A) axial plane, B) coronal plane, C) sagittal plane .
Figure 3
Figure 3
Overall classification accuracy for the different images using the International Frontal Sinus Anatomy Classification. Poor: score = less than 60%; good: score = 60% or more.
Appendix 2
Appendix 2
Two-way mixed effect model where people effects are random and measures effects are fixed.
Appendix 3
Appendix 3
Modified Kuhn classification of frontal ethmoidal cells.
See this image and copyright information in PMC

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