Olfactory Fossa Depth Assessment Based on Keros Classification using Computed Tomography
Keywords:
Keros classification, Olfactory fossa, Paranasal sinuses, Radiological assessmentAbstract
ABSTRACT:
Objective: To evaluate the olfactory fossa depth and to categorize it according to Keros classification.
Methodology: It was a cross sectional study done on 270 adults , 160 males and 110 females at Ziauddin University Hospital,
Clifton, Karachi using CT Para nasal sinuses. The depth of olfactory fossa was evaluated by measuring the height of lateral
lamina of cribriform plate.
Results: The mean and standard deviation(SD) of right olfactory fossa depth was greater than that of left 6.184±1.8237mm
and 5.949 ±1.8003mm (p value 0.006) respectively. Mean ± (SD) for left olfactory fossa depth was greater in females
(6.215±1.9271) than in males (5.766±1.6896) (p value 0.043).
Keros type II was found to be the most frequent on both right and left sides that is, in 69.26% and 72.96% individuals respectively
followed by type III on right side in 18.15% and on left side in 15.19% subjects. Type I was found to be the least frequent in
our population with a value of 12.59% on the right side and 11.85% on the left side.
Conclusion: Our study shows that most of the population falls in the high risk categories of Keros that is type II and type III
thus emphasizing the need of preoperative radiological assessment.
References
Kaplanoglu H, Kaplanoglu V, Dilli A, Toprak U, Hekimo lu B. An analysis of the anatomic variations of the paranasal sinuses and ethmoid roof using computed tomography. The Eurasian journal of medicine. 2013;45(2):115-125
Salroo IN, Dar NH, Yousuf A, Lone KS. Computerised tomographic profile of ethmoid roof on basis of keros classification among ethnic Kashmiri’s. International Journal of Otorhinolaryngology and Head and Neck Surgery. 2016; 2(1):1-5
Paber JEL, Cabato MSD, Villarta RL, Hernanadez JG. Radiographic analysis of the ethmoid roof based on Keros classification among Filipinos. Philippine Journal of Otolaryngology Head and Neck Surgery. 2008;23(1):15- 9
McMains KC. Safety in endoscopic sinus surgery. Current opinion in otolaryngology & head and neck surgery. 2008; 16(3):247-51
Souza SA, Souza MMAd, Idagawa M, Wolosker ÂMB, Ajzen SA. Computed Tomography assessment of the ethmoid roof: a relevant region at risk in endoscopic sinus surgery. Radiologia Brasileira. 2008;41(3):143-7
Adeel M, Rajput MSA, Akhter S, Ikram M, Arain A, Khattak YJ. Anatomical variations of nose and para- nasal sinuses; CT scan review. Journal of the Pakistan Medical Association. 2013; 63(3):317-19
Cashman EC, MacMahon PJ, Smyth D. Computed tom- ography scans of paranasal sinuses before functional endoscopic sinus surgery. World J Radiol. 2011;3(8):199- 204
Reddy UDMA, Dev B. Pictorial essay: Anatomical variations of paranasal sinuses on multidetector computed tomography-How does it help FESS surgeons? The Indian journal of radiology & imaging. 2012;22(4):317
Heskova G, Mellova Y, Holomanova A, Vybohova D, Kunertova L, Marcekova M, et al. Assessment of the relation of the optic nerve to the posterior ethmoid and sphenoid sinuses by computed tomography. Biomedical Papers. 2009;153(2):149-52
Souza SA, de Souza MMA, Gregório LC, Ajzen S. An- terior ethmoidal artery evaluation on coronal CT scans. Brazilian journal of otorhinolaryngology. 2009;75(1):101- 6
Araujo Filho BC, Weber R, Neto CDP, Lessa MM, Vo- egels RL, Butugan O. Endoscopic anatomy of the anterior ethmoidal artery: a cadaveric dissection study. Brazilian journal of otorhinolaryngology.2006;72(3):303- 8
Keros P. On the practical value of differences in the level of the lamina cribrosa of the ethmoid. Zeitschrift fur Laryngologie, Rhinologie, Otologie und ihre Grenzgebiete. 1962;41:809
Alazzawi S, Omar R, Rahmat K, Alli K. Radiological analysis of the ethmoid roof in the Malaysian population. Auris Nasus Larynx. 2012;39(4):393-6
Adeel M, Ikram M, Rajput MSA, Arain A, Khattak YJ. Asymmetry of lateral lamella of the cribriform plate: a software-based analysis of coronal computed tomography and its clinical relevance in endoscopic sinus surgery. Surgical and Radiologic Anatomy. 2013;35(9):843-7
Shama SA, Montaser M. Variations of the height of the ethmoid roof among Egyptian adult population: MDCT study. The Egyptian Journal of Radiology and Nuclear Medicine. 2015;46(4):929-36
Emirzeoglu M, Sahin B, Bilgic S, Celebi M, Uzun A. Volumetric evaluation of the paranasal sinuses in normal subjects using computer tomography images: a stereol- ogical study. Auris Nasus Larynx. 2007;34(2):191-5
Ulualp SO. Complications of endoscopic sinus surgery: appropriate management of complications. Current opinion in otolaryngology & head and neck surgery. 2008;16(3):252-9
Erdem G, Erdem T, Miman MC, Ozturan O. A radiological anatomic study of the cribriform plate compared with constant structures. Rhinology. 2004;42(4):225-9
Ameye S, Amusa Y, Eziyi J, Famurewa O. Assessing the surgical anatomy of the ethmoid sinus in adult Nigerians using computerized tomography scan.International Journal of Medicine and Medical Sciences.2014;6(12):239-44
Rathnakar P, Shrinath D, Kamath P. Computed Tom
-ographic study of depth of Anterior Skull Base in Dakshina Kannada population. International Journal of Anatomy and Research. 2016; 4(3):2738-42
Nitinavakarn B, Thanaviratananich S, Sangsilp N. Ana- tomical variations of the lateral nasal wall and paranasal sinuses: a CT study for endoscopic sinus surgery (ESS) in Thai patients. J Med Assoc Thai. 2005;88(6):763-8
Elwany S, Medanni A, Eid M, Aly A, El-Daly A, Ammar
S. Radiological observations on the olfactory fossa and ethmoid roof. The Journal of Laryngology & Otology. 2010; 124(12): 1251-6
achin C, Yilmaz Y, Titiz A, Özcan M, Özlgedik S, Ünal A.Analysis of Ethmoid Roof and CranialBase in Turkish Population. KBB ve BBC Dergisi.2007;15:1-6
Solares CA, Lee WT, Batra PS, Citardi MJ. Lateral lamella of the cribriform plate: software-enabled computed tomographic analysis and its clinical relevance in skull base surgery. Archives of Otolaryngology–Head & Neck Surgery. 2008;134(3):285-9
Nouraei S, Elisay A, Dimarco A, Abdi R, Majidi H, Mad- ani S, et al. Variations in paranasal sinus anatomy: implications for the pathophysiology of chronic rhinosinusitis and safety of endoscopic sinus surgery. Journal of Otolaryngology-Head and Neck Surgery. 2009;38(1):324
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2017 Mubina Lakhani, Nuzhat Hassan, Arsalan Manzoor, Muhammad Ali, Madeeha Sadiq
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Journal of Bahria University Medical & Dental College is an open access journal and is licensed under CC BY-NC 4.0. which permits unrestricted non commercial use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc/4.0 
