Asymmetry of lateral lamella of the cribriform plate: a software-based analysis of coronal computed tomography and its clinical relevance in endoscopic sinus surgery

Adeel, Mohammad; Ikram, Mubasher; Rajput, Mohammad Shaheryar Ahmed; Arain, Asif Ali; Khattak, Yasir Jamil

doi:10.1007/s00276-013-1106-4

Cited by 36 publications

(29 citation statements)

References 17 publications

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“…Similar findings to Keros's study have been reported in in various countries such as South Korea [15], Turkey [18], Turkey [19], Turkey [20], Turkey [21], Turkey [22] , Thailand [23], Brazil [10], Germany [24], Egypt [25], Pakistan [26], Poland [27], Saudi Arabia [28], India [29], India [30] , and Iran [31]. Unlike to Keros study [9], and similar studies [10,15,[18][19][20][21][22][23][24][25][26][27][28][29][30][31] our findings showed that Type I is the most common type (71.0%), followed by Type II (27.4%) and the Type III (1.6%) of the cases, respectively. However, our findings inline to results reported in studies from Philippine [16], USA [32], UK [33], Nepal [34], Malaysia [35], and Egypt [36] which confirms that the Keros type I is the most common.…”

Section: Discussionsupporting

confidence: 90%

Computed tomography assessment of the ethmoid roof based on Keros classification in Iraqi patients undergoing functional endoscopic sinus surgery

2021

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Background: Among the most popular methods employed to classify the depth of the olfactory fossa is Keros classification. This study aims to assess Keros classification of the ethmoid roof, any possible association between Keros types and gender, and the incidence of asymmetry between right and left sides among Iraqi patients. Methods: A retrospective cross-sectional study was conducted at Al-Shaheed Gazi Al-Hariri Teaching Hospital, Medical City, Baghdad, Iraq. The archived reports and the CT scans images (nose and paranasal sinuses) of 126 patients who have undergone functional endoscopic sinus surgery between January 2019 and January 2020 were reviewed. Univariate and bivariate statistical analysis was performed using SPSS version 24. The statistically significant was considered at less than 0.05. Results: More than half of patients were females (54.0%) with a mean age of 31.52 ± 11.38 (SD) years (range: 10-57 years). Among the total patients, the mean depth of olfactory fossa (OF) was 3.58 ± 0.02 mm. Results showed that Keros type I was the most common type (71.0%), followed by type II (27.4%) and type III (1.6%) respectively. The difference in the olfactory fossa depth between the right and left sides was ≥ 1 mm in 16 (12.7%) patients and < 1 mm in 110 (87.3%) patients. Moreover, there was no significant relation between symmetry/asymmetry and gender ( p-value > 0.05). Conclusion: Keros type I was the most common type, which carries the lowest risk of inadvertent intracranial injury during endoscopic sinus surgery; besides the relatively low percentage of asymmetry in the depth of the two olfactory fossae among patients, surgeons should always be cautious during surgery to avoid iatrogenic injury concerning the thin lateral lamella of the cribriform plate.

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Section: Discussionsupporting

confidence: 90%

Computed tomography assessment of the ethmoid roof based on Keros classification in Iraqi patients undergoing functional endoscopic sinus surgery

2021

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“…51 This is the point of highest surgical risk. 52 Several methods have been proposed to identify the AEC: Kirchner et al, in 1961, 53 used the maxillo-lacrimal suture, while Lang 54 suggested the cribriform Fig. 3 Comparison between the same image as obtained by means of 3D direct volume rendering (A) and computed tomography (B).…”

Section: Discussionmentioning

confidence: 99%

In Vivo Computed Tomography Direct Volume Rendering of the Anterior Ethmoidal Artery: A Descriptive Anatomical Study

Cacciola

Portaro

Basile

et al. 2020

Int Arch Otorhinolaryngol

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Several studies demonstrated that the AEC is not always continuous in its bony structure, but it may show a partial or complete bone dehiscence in its most caudal portion. 1,3,4 Significant intrasubject side-to-side variability may exist so that the bony canal can be complete on one side and partially or completely open on the other one.Moreover, useful information about the distance of the AEA from the columella, 5 the middle turbinate axilla and the nasal valve 1,6 has been provided. AbstractIntroduction The clinical relevance of the anatomy and variations of the anterior ethmoidal artery (AEA) is outstanding, considering its role as a landmark in endoscopic surgery, its importance in the therapy of epistaxis, and the high risks related to iatrogenic injuries. Objective To provide an anatomical description of the course and relationships of the AEA, based on direct computed-tomography (CT)-based 3D volume rendering. Methods Direct volume rendering was performed on 18 subjects who underwent (CT) with contrast medium for suspected cerebral aneurism. Results The topographical location of 36 AEAs was assessed as shown: 10 dehiscent (27.8%), 20 intracanal (55.5%), 6 incomplete canals (16.7%). Distances from important topographic landmarks are reported. Conclusion This work demonstrates that direct 3D volume rendering is a valid imaging technique for a detailed description of the anterior ethmoidal artery thus representing a useful tool for head pre-operatory assessments.

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“…Endoscopic sinus surgery is a surgical procedure in which the sinus cells are opened to improve ventilation of sinuses and mucociliary clearance. (8) This procedure is widely accepted as treatment of many conditions involving paranasal sinuses, however; many complications might be encountered such as orbital hemorrhage, loss of vision, anosmia, injury to nasolacrimal duct, CSF leak, meningitis and brain abscess. A major risk in ESS is iatrogenic perforation of base of skull, and the most vulnerable area for this is the LLCP which is the thinnest structure in anterior skull base.…”

Section: Discussionmentioning

confidence: 99%

Keros Classification among Jordanian Population

Athamneh¹,

Hazaimeh²,

Shawaqfeh³

et al. 2015

JRMS

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Objectives: To evaluate the prevalence of each KEROS subclass among Jordanian population, and to compare between subclass distribution in right and left side, and also between different genders. Methods: Retrospectively evaluating computed tomography studies for paranasal sinuses of 100 different patients, the depth of lateral lamellae of cribriform plate was measured and this was plotted against the different subtypes of Keros classes considering gender variations. Results: The favorable classes were found to be II, I and III in order, having percentages of 70.5%, 22% and 7.5% respectively. Minimal male to female variations were found as well as minimal right to left variations. Racial variations were noted when comparing our study results to other studies worldwide. Conclusion: Significant racial variation is noted when considering Keros classification among population. Keros categorization of patients is emphasized when performing paranasal sinuses Computed Tomography.

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Asymmetry of lateral lamella of the cribriform plate: a software-based analysis of coronal computed tomography and its clinical relevance in endoscopic sinus surgery

Abstract: Understanding of the anatomy of ethmoid roof with its possible variation is crucial to give the surgeon optimal information about the possible risk that one can face during the surgery. Hence dreadful complications can be avoided.

Cited by 36 publications

References 17 publications

Computed tomography assessment of the ethmoid roof based on Keros classification in Iraqi patients undergoing functional endoscopic sinus surgery

Computed tomography assessment of the ethmoid roof based on Keros classification in Iraqi patients undergoing functional endoscopic sinus surgery

In Vivo Computed Tomography Direct Volume Rendering of the Anterior Ethmoidal Artery: A Descriptive Anatomical Study

Keros Classification among Jordanian Population

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