{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T23:31:44Z","timestamp":1783467104547,"version":"3.55.0"},"reference-count":11,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,12,5]],"date-time":"2016-12-05T00:00:00Z","timestamp":1480896000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2017,4]]},"abstract":"Background<\/jats:title>The frontal sinus is considered the most challenging sinus to address surgically. There are no current classifications of the degree of surgical complexity of different frontal sinus configurations. The aim of this study is to develop a classification system of the degree of complexity of frontal recess surgery based on preoperative computed tomography (CT) scans.<\/jats:p><\/jats:sec>Methods<\/jats:title>Authors were asked to submit a classification system. These were circulated to all authors. Selection of the final 3 classifications was based on a majority consensus. These classifications were compared further for time\u2010taken, ease\u2010of\u2010use, and interrater agreement. These were assessed by the authors on 10 CT scans representing a range of anticipated surgical difficulty.<\/jats:p><\/jats:sec>Results<\/jats:title>Out of 3 compared classifications, classification A was the quickest to score (1.44 minutes vs 1.57 minutes and 2.25 minutes), subjectively easiest (3.23 vs 4.07 and 5 on a visual analogue scale [VAS]), and had a moderate interrater agreement (0.52 vs 0.42 and 0.79). In addition, the grading of complexity was as good whether measurements were taken on the CT scans or whether size of the frontal ostium was visually estimated.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>We propose a fast, easy classification to anticipate the complexity of surgery in the frontal sinus and recess, for patients undergoing primary surgery.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.21893","type":"journal-article","created":{"date-parts":[[2016,12,5]],"date-time":"2016-12-05T11:26:53Z","timestamp":1480937213000},"page":"332-337","source":"Crossref","is-referenced-by-count":21,"title":["The International Classification of the radiological Complexity (ICC) of frontal recess and frontal sinus"],"prefix":"10.1002","volume":"7","author":[{"given":"Peter John","family":"Wormald","sequence":"first","affiliation":[{"name":"Department of Surgery\u2013Otolaryngology University of Adelaide Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Bassiouni","sequence":"additional","affiliation":[{"name":"Department of Surgery\u2013Otolaryngology University of Adelaide Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio A.","family":"Callejas","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Pontificia Universidad Cat\u00f3lica de Chile Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Pennsylvania Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin J.","family":"Citardi","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Texas McGovern Medical School at Houston Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy L.","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Rhinology and Sinus\/Skull Base Surgery Oregon Health and Science University Portland OR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard R.","family":"Orlandi","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology Head and Neck Surgery University of Utah Salt Lake City UT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Kaschke","sequence":"additional","affiliation":[{"name":"Department of ENT Sankt Gertrauden Krankenhaus Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Keat","family":"Siow","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Tan Tock Seng Hospital National University of Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kornel","family":"Szczygielski","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Military Institute of Medicine Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Lund","sequence":"additional","affiliation":[{"name":"Professorial Unit, Royal National Throat Nose Ear Hospital University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wytske","family":"Fokkens","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Academic Medical Centre Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alkis J.","family":"Psaltis","sequence":"additional","affiliation":[{"name":"Department of Surgery\u2013Otolaryngology University of Adelaide Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,12,5]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21015"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhin11.266"},{"key":"e_1_2_6_4_1","first-page":"82","article-title":"Surgery of the frontal recess and frontal sinus","volume":"43","author":"Wormald P\u2010J","year":"2005","journal-title":"Rhinology"},{"key":"e_1_2_6_5_1","first-page":"304","volume-title":"Endoscopic Sinus Surgery: Anatomy, Three\u2010Dimensional Reconstruction, and Surgical Technique","author":"Wormald PJ","year":"2012"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.3342\/ceo.2010.3.2.76"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21738"},{"key":"e_1_2_6_8_1","first-page":"428","volume-title":"Handbook of Inter\u2010Rater Reliability: The Definitive Guide to Measuring the Extent of 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