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

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.