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Introduction: Growth and development of paranasal sinuses affect different orthodontic malocclusions playing an important role in the formation of facial anatomy.

Objective: To compare the dimensions of frontal sinus among different skeletal relations, gender groups and to analyse the relationship between length of the mandible and frontal sinus dimensions.

Materials and Method: An analytical cross-sectional study was conducted during April-September 2020 at Kantipur Dental College. The sample consisted of 195 lateral cephalograms with 65 samples each in three different skeletal malocclusion groups of Nepali individuals. The subjects with paranasal sinus pathology and history of previous orthodontic treatment were excluded. The samples were manually traced and analysed by measuring maximum width, maximum height, area of frontal sinus, and length of the mandible. One-way analysis of variance test was performed followed by post hoc test to compare the difference between skeletal classes. Independent t-test was done to compare the gender difference at P <0.05.

Result: Statistically significant differences were observed in maximum width, area of frontal sinus and length of mandible with respect to skeletal malocclusions. The frontal sinus area was largest in Class III and smallest in Class II group. Significant difference was observed in frontal sinus measurements between the gender groups.

Conclusion: Frontal sinus area was found to be the largest in Class III and smallest in Class II. These variations in the measurements of frontal sinus should be considered in diagnosis and treatment planning of orthodontic and orthognathic cases.

Frontal sinus; lateral cephalometry; skeletal pattern.