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Frontal Sinus

Anatomy and Physiology · NLM MeSH · updated 2026-10-31 · version 1

Citations verified against PubMedNot yet clinician-reviewed10 referencesApproximately 5 min read

One of the paired, but seldom symmetrical, air spaces located between the inner and outer compact layers of the frontal bone in the forehead.

Table of Contents

1. Definition2. Research landscape3. Reading the evidence4. Open-access studies5. Key reviews6. References7. About this article

Definition and research guide

This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.

Content available: 4 complete abstracts (895 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.

Definition

One of the paired, but seldom symmetrical, air spaces located between the inner and outer compact layers of the frontal bone in the forehead.

Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.

Also known as: Sinus, Frontal; Agger Nasi Cell; Agger Nasi Cells; Cell, Agger Nasi; Frontal Recess; Frontal Recesses; Recess, Frontal; Frontal Sinus Ostium.

Where it fits in the MeSH classification

Broader topics
Paranasal Sinuses

Related concepts

  • Frontal Bone

Research landscape

PubMed indexes 4,319 records tagged with the MeSH heading “Frontal Sinus” (counts retrieved 2026-10-31). 449 of them (10.4%) were published from 2020 onward, and the busiest period so far is through 1999 with 2,304 records.

Reviews account for 308 records (7.1%) and meta-analyses for 14. Randomized controlled trials number 21 (0.5%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.

PubMed records by publication periodthrough 1999: 2,304 records; 2000-2009: 711 records; 2010-2019: 855 records; 2020 onward: 449 records2,304through 19997112000-20098552010-20194492020 onward
Records in PubMed indexed with this heading, by publication period. Real counts from NCBI E-utilities; the final period covers only part of the current year. Volume reflects how much has been published, not how strong the evidence is.
Show the data
PeriodRecords
through 19992,304
2000-2009711
2010-2019855
2020 onward449
Share of records by publication typeReviews: 7.1 percent; Meta-analyses: 0.3 percent; Randomized controlled trials: 0.5 percentReviews7.1% (308)Meta-analyses0.3% (14)Randomized controlled trials0.5% (21)
Share of all PubMed records on this heading that carry each publication type. Types overlap with other records, so the shares do not sum to 100%.
Publication-type chart data
Publication types among 4,319 PubMed records
TypeRecordsShare
Reviews3087.1%
Meta-analyses140.3%
Randomized controlled trials210.5%

Method: PubMed query "Frontal Sinus"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-31.

Reading the evidence in anatomy and physiology

Anatomy describes how body structures are built and physiology describes how they normally work, so most findings here are descriptive or mechanistic rather than evidence about treatment. Much of what is known comes from dissection, imaging, tissue studies and experiments in animals, and measurements in healthy volunteers can differ from those in people with disease or at different ages. Normal ranges vary between individuals and populations. Check whether a result was measured in people or in another species, the age and health of the participants, and the method used.

Evidence from open-access studies

These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.

Study comparison — selected abstracts, not a systematic review
Study / authorsYearSource label / designEurope PMC citationsLicence / source
Computed tomography measurements of different dimensions of maxillary and frontal sinuses
Sahlstrand-Johnson P, Jannert M, Strömbeck A, Abul-Kasim K
2011Research article
Design not recorded in structured metadata
86cc by
PMID 21466703 · DOI · PMC3080316
Surgery of frontal sinus fractures: epidemiologic study and evaluation of techniques
Montovani JC, Nogueira EA, Ferreira FD, Lima Neto AC, Nakajima V
2006Research article
Design not recorded in structured metadata
23cc by
PMID 16951853 · DOI · PMC9445745
Pott's puffy tumor: a need for interdisciplinary diagnosis and treatment
Kühn JP, Linsler S, Nourkami-Tutdibi N, Meyer S, Becker SL, Yilmaz U, et al.
2022Research article
Design not recorded in structured metadata
17cc by
PMID 35072731 · DOI · PMC8837573
Nasal Branch of the Anterior Ethmoidal Artery and Cribroethmoidal Groove: New Frontal Sinus Landmarks
Vinciguerra A, Turri-Zanoni M, Bettini P, Arosio AD, Gandolfi A, Balzi D, et al.
2026Research article
Design not recorded in structured metadata
1cc by
PMID 40801181 · DOI · PMC12770801

Computed tomography measurements of different dimensions of maxillary and frontal sinuses [1]

Research article Sahlstrand-Johnson P, Jannert M, Strömbeck A, Abul-Kasim K · · 2011 · cited 86 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
BackgroundWe have previously proposed the use of Doppler ultrasound to non-invasively stage sinus infection, as we showed that acoustic streaming could be generated in nonpurulent sinus secretions and helped to distinguish it from mucopurulent sinus secretions.
Closing excerpt
We believe that our data are necessary for further development of a clinically applicable Doppler equipment for staging rhinosinusitis.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (299 words)

BackgroundWe have previously proposed the use of Doppler ultrasound to non-invasively stage sinus infection, as we showed that acoustic streaming could be generated in nonpurulent sinus secretions and helped to distinguish it from mucopurulent sinus secretions. In order to continue this development of a clinically applicable Doppler equipment, we need to determine different dimensions of the paranasal sinuses, especially the thickness of the anterior wall of the maxillary sinus (at the canine fossa). To the best of our knowledge, this is the first report on the thickness of the canine fossa. This study aimed to (a) estimate different dimensions of the maxillary and frontal sinuses measured on computed tomography (CT) of the head, (b) define cut-off values for the normal upper and lower limits of the different measured structures, (c) determine differences in age, side and gender, (d) compare manually and automatically estimated maxillary sinuses volumes, and (e) present incidental findings in the paranasal sinuses among the study patients.MethodsDimensions of 120 maxillary and frontal sinuses from head CTs were measured independently by two radiologists.ResultsThe mean value of the maxillary sinus volume was 15.7±5.3 cm3 and significantly larger in males than in females (P=0.004). There was no statistically significant correlation between the volume of maxillary sinuses with age or side. The mean value of the bone thickness at the canine fossa was 1.1±0.4 mm. The automatically estimated volume of the maxillary sinuses was 14-17% higher than the calculated volume. There was high interobserver agreement with regard to the different measurements performed in this study. Different types of incidental findings of the paranasal sinuses were found in 35% of the patients.ConclusionWe presented different dimensions of the maxillary and frontal sinuses on CTs. We believe that our data are necessary for further development of a clinically applicable Doppler equipment for staging rhinosinusitis.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 21466703 · DOI · PMC3080316

Surgery of frontal sinus fractures: epidemiologic study and evaluation of techniques [2]

Research article Montovani JC, Nogueira EA, Ferreira FD, Lima Neto AC, Nakajima V · · 2006 · cited 23 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
UnlabelledThe frontal sinus trauma is not rare and it is 8% of the facial fractures.
Closing excerpt
The surgical techniques used are the incisions, bicoronal flap or brow-glabella, infra-orbital rim ("butterfly"), associated a endoscopy sinus surgery in cases of infection, cerebrospinal fluid leak and orbital complications.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (225 words)

UnlabelledThe frontal sinus trauma is not rare and it is 8% of the facial fractures. It can affect the anterior and/or posterior plates, with or without hitting the nasofrontal duct. It has a large potential of complications and its management still being a controversy.ObjectiveTo present the casuistic of fractures frontal sinus, the epidemiology and clinical and surgical management of frontal sinus fractures.Materials and methodsNot randomized retrospective study of 24 patients with frontal sinus fractures Hospital of Clinics, School of Medicine Botucatu, São Paulo, Brazil.ResultsFrom the 24 patients, we had 16 (66,6%) fractures of the extern plate and 8 (33,4%) of both. In 2 patients the nasofrontal duct was involved. Others facial fractures were associated in 20 (83,4%) cases and major lesions of the cerebral segment were found in 13 (54,2%). Subpalpebral incision was performed in the majority with satisfactory aesthetic results. The basis of the surgical treatment was reduction and fixation with different materials (steel wire, mononylon, titanium miniplates) and if necessary we used alogen implants or parietal bone to reconstruct the anterior plate.ConclusionThe principal cause of frontal sinus fractures is crashed car. The management depends of the complexity, because commonly there are cranioencephalic lesions associated. The surgical techniques used are the incisions, bicoronal flap or brow-glabella, infra-orbital rim ("butterfly"), associated a endoscopy sinus surgery in cases of infection, cerebrospinal fluid leak and orbital complications.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 16951853 · DOI · PMC9445745

Pott's puffy tumor: a need for interdisciplinary diagnosis and treatment [3]

Research article Kühn JP, Linsler S, Nourkami-Tutdibi N, Meyer S, Becker SL, Yilmaz U, et al. · · 2022 · cited 17 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Pott's puffy tumor (PPT) is an infection of the frontal sinus with subperiosteal and intracranial abscess formation and one of the rare entities in pediatrics.
Closing excerpt
Therefore, a close interdisciplinary cooperation for successful treatment is needed in this rare disease.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (129 words)

Pott's puffy tumor (PPT) is an infection of the frontal sinus with subperiosteal and intracranial abscess formation and one of the rare entities in pediatrics. We present a series of four cases of PPT that occurred in two children (6 and 9 years) and in two young adults (17 and 19 years). All patients were treated by an interdisciplinary team of pediatric, neurosurgical, ENT, radiological, and neuroradiological specialists. Antibiotic treatment was combined with single endoscopic surgery in one case and combined endoscopic sinus surgery with an open transcranial approach to drain intracranial abscess formation in three cases. It is important to be aware that PPT occurs in children with the finding of intracranial abscess formation. Therefore, a close interdisciplinary cooperation for successful treatment is needed in this rare disease.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 35072731 · DOI · PMC8837573

Nasal Branch of the Anterior Ethmoidal Artery and Cribroethmoidal Groove: New Frontal Sinus Landmarks [4]

Research article Vinciguerra A, Turri-Zanoni M, Bettini P, Arosio AD, Gandolfi A, Balzi D, et al. · · 2026 · cited 1 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
ObjectiveExpanded frontal sinusotomies (Draf IIb/c-III) are essential surgical procedures for managing complex frontal sinus pathologies.
Closing excerpt
Level of evidenceLevel 4.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (242 words)

ObjectiveExpanded frontal sinusotomies (Draf IIb/c-III) are essential surgical procedures for managing complex frontal sinus pathologies. However, traditional anatomical landmarks may be difficult to identify, particularly in tumor or revision cases. This manuscript investigates the nasal branch of the anterior ethmoidal artery (NbAEA) and the cribroethmoidal groove (CrEGr) as reliable and consistent landmarks for endoscopic frontal sinusotomies.MethodsThis study included anatomical dissections (medio-lateral approach) on three fresh cadavers (six sides) focused on the region anterior to the first olfactory phylum, namely the cribo-frontal area. Additionally, a retrospective clinical case series of patients that underwent centripetal dissection with a medio-lateral approach to the frontal sinus was performed. Identification of NbAEA, CrEGr, and the first olfactory phylum, along with surgical outcomes and complications, was analyzed.ResultsThe NbAEA and CrEGr were identified in all dissected sides and were located anterior to the first olfactory phylum. Considering the 19 enrolled patients, 13/19 (68.4%) were treated with a bilateral centripetal dissection and Draf III procedure (26 sides); whereas 6/19 patients (31.6%) underwent a unilateral approach with a Draf IIb/c procedure. The NbAEA and CrEGr were identified in all cases (100%) and in only 9/19 cases (47.7%) the first olfactory phylum was additionally exposed, reinforcing the role of these new anatomical landmarks. No perioperative complications were recorded.ConclusionsThis study supports the clinical significance of NbAEA and CrEGr as reliable anatomical landmarks, and their identification in 100% of cases reinforces their practical applicability in surgical approaches to the frontal sinus.Level of evidenceLevel 4.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 40801181 · DOI · PMC12770801

Key reviews and meta-analyses

The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.

  • Research article Management of frontal sinus fractures. Changing concepts [5]
    Rohrich RJ, Hollier LH · Clin Plast Surg · 1992 · cited 111 times (Europe PMC)
  • Research article Identification by frontal sinus pattern in forensic anthropology [6]
    Quatrehomme G, Fronty P, Sapanet M, Grévin G, Bailet P, Ollier A · Forensic Sci Int · 1996 · cited 87 times (Europe PMC)
  • Research article Safety and efficacy of the endoscopic modified Lothrop procedure: a systematic review and meta-analysis [7]
    Anderson P, Sindwani R · Laryngoscope · 2009 · cited 73 times (Europe PMC)
  • Research article The impact of Daubert: implications for testimony and research in forensic anthropology (and the use of frontal sinuses in personal identification) [8]
    Christensen AM · J Forensic Sci · 2004 · cited 67 times (Europe PMC)
  • Research article Clinically relevant frontal sinus anatomy and physiology [9]
    McLaughlin RB, Rehl RM, Lanza DC · Otolaryngol Clin North Am · 2001 · cited 58 times (Europe PMC)
  • Research article Outcomes After Frontal Sinus Surgery: An Evidence-Based Review [10]
    DeConde AS, Smith TL · Otolaryngol Clin North Am · 2016 · cited 50 times (Europe PMC)

References

  1. Sahlstrand-Johnson P, Jannert M, Strömbeck A, Abul-Kasim K. Computed tomography measurements of different dimensions of maxillary and frontal sinuses. . 2011. PMID 21466703 · DOI · PMC3080316
  2. Montovani JC, Nogueira EA, Ferreira FD, Lima Neto AC, Nakajima V. Surgery of frontal sinus fractures: epidemiologic study and evaluation of techniques. . 2006. PMID 16951853 · DOI · PMC9445745
  3. Kühn JP, Linsler S, Nourkami-Tutdibi N, Meyer S, Becker SL, Yilmaz U, et al.. Pott's puffy tumor: a need for interdisciplinary diagnosis and treatment. . 2022. PMID 35072731 · DOI · PMC8837573
  4. Vinciguerra A, Turri-Zanoni M, Bettini P, Arosio AD, Gandolfi A, Balzi D, et al.. Nasal Branch of the Anterior Ethmoidal Artery and Cribroethmoidal Groove: New Frontal Sinus Landmarks. . 2026. PMID 40801181 · DOI · PMC12770801
  5. Rohrich RJ, Hollier LH. Management of frontal sinus fractures. Changing concepts. Clin Plast Surg. 1992. PMID 1537220 · DOI
  6. Quatrehomme G, Fronty P, Sapanet M, Grévin G, Bailet P, Ollier A. Identification by frontal sinus pattern in forensic anthropology. Forensic Sci Int. 1996. PMID 9022276 · DOI
  7. Anderson P, Sindwani R. Safety and efficacy of the endoscopic modified Lothrop procedure: a systematic review and meta-analysis. Laryngoscope. 2009. PMID 19554631 · DOI
  8. Christensen AM. The impact of Daubert: implications for testimony and research in forensic anthropology (and the use of frontal sinuses in personal identification). J Forensic Sci. 2004. PMID 15171154 · DOI
  9. McLaughlin RB, Rehl RM, Lanza DC. Clinically relevant frontal sinus anatomy and physiology. Otolaryngol Clin North Am. 2001. PMID 11344058 · DOI
  10. DeConde AS, Smith TL. Outcomes After Frontal Sinus Surgery: An Evidence-Based Review. Otolaryngol Clin North Am. 2016. PMID 27450618 · DOI · PMC4964596

About this article

Sources
NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
Verification
Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
Review state
automated source verified; no human expert review has been recorded yet.
Version
1, last updated 2026-10-31.

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At a glance

4,319
PubMed records on this heading
10%
published since 2020
308
review articles
21
randomized trials
10
verified references below

Counts come from PubMed on 2026-10-31; they show how much has been written, not how strong the evidence is.

Related topics See all →

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  • Paranasal SinusesAnatomy and Physiology
  • Bone Marrow CellsAnatomy and Physiology
  • Chromaffin CellsAnatomy and Physiology

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