Development and Validation of a Systematic and Reliable Computed Tomography Measurement Method for Ethmoid Sinus and Frontal Recess Dimensions in Chronic Rhinosinusitis

Tailoring endoscopic sinus surgery for patient management requires surgeons to consider disease severity and patients’ sinonasal anatomy. This paper introduces a systematic and reliable measurement protocol to assess the dimensions of the ethmoid sinuses and frontal recess, thereby providing a consistent way to capture and quantify this region of anatomic complexity. This study was a retrospective chart review of surgical cases performed between January 2020 and December 2021. An initial protocol was developed that used numerous easily identifiable landmarks on computed tomography imaging to measure ethmoid sinus and frontal recess dimensions. This protocol was then applied retrospectively to 40 patients requiring endoscopic sinus surgery (ESS). The same measurements were completed by three separate reviewers and repeated by one reviewer to determine interrater and intrarater reliability using the intraclass correlation coefficient (ICC). Most measurements were found to have good (ICC 0.75–0.9) to excellent (ICC > 0.9) interrater and intrarater reliability. A subset of measurements demonstrating the highest interrater and intrarater reliability while capturing all relevant dimensions of the frontal and ethmoid sinuses was selected to create the final measurement protocol. This is the first study to establish a systematic and reliable measurement protocol of the ethmoid sinus and frontal recess designed for practical use by clinicians and researchers. These values provide a reliable reference for clinical comparison and will allow clinicians and researchers to assess ethmoid sinus and frontal recess dimensions with reliability and validity.