Cone Beam Computed Tomography-Based Anatomical Assessment of the Olfactory Fossa

Costa, André Luiz Ferreira; Paixão, Aline Kataki; Gonçalves, Bianca Costa; Ogawa, Celso Massahiro; Martinelli, Thiago H.; Maeda, Fernando Akio; Triviño, Tarcila; Lopes, Sérgio Lúcio Pereira de Castro

doi:10.1155/2019/4134260

Cited by 13 publications

(16 citation statements)

References 27 publications

(39 reference statements)

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“…In our study, the most common were Keros type II (71.9%), followed by Keros type I (17.8%), Keros type III (10.3%). While a few studies reported the most common Keros type I [1,2,7,20,21], most studies were the most common type II [3][4][5]8,[13][14][15][17][18][19][22][23][24][25][26][27][28], consistent with our study. The distributions according to the Keros classification in the studies conducted in the Turkish population are presented in Table 6.…”

Section: Discussionsupporting

confidence: 90%

“…The mean widths of OF and CP were statistically significant in our study. Unlike other studies, in our study, the mean CP depth was statistically significant according to the side [1,13,16]. The mean CP depth on the left was greater than the right.…”

Section: Discussioncontrasting

confidence: 86%

“…They reported that CBCT gave equivalent results in the assessment of CP and OF with lower doses relative to CT. However, few studies have evaluated OF using CBCT [6,[13][14][15]. Therefore, in this study, we showed that the region of OF can be evaluated with CBCT and to provide a detailed examination of the relevant region.…”

Section: Discussionmentioning

confidence: 83%

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Radiological Evaluation of Olfactory Fossa with Cone-Beam Computed Tomography

Keşkek¹,

Aytuğar

2021

JOMR

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Objectives:The aim of this retrospective study was to evaluate the morphology of the olfactory fossa in the Turkish population using cone-beam computed tomography according to Keros classification and to investigate the effect of age, gender and nasal septum deviation on the olfactory fossa. Material and Methods: Olfactory fossa (OF) were analysed in coronal sections on cone-beam computed tomography images of 385 individuals. Nasal floor (NF), medial ethmoid roof point (MERP), cribriform plate (CP) heights, CP depth and width, OF width, lateral lamella-cribriform plate angle (LLCPA), and nasal septum deviation angle (NSDA) were measured. Keros and Gera classifications were made according to the measurements. Results: According to the Keros classification, 137 of 770 OFs were type I (17.8%), 554 (71.9%) were type II, and 79 (10.3%) were type III. The most common combination was Keros type II and Gera type II (45.6%). There was a positive correlation between CP depth and LLCP angle, NF, MERP and CP heights (P ≤ 0.05). NF, MERP, and CP heights, CP depth and LLCP angle were statistically significant differences according to Keros classification (P ≤ 0.05). Only the right LLCP angle showed a statistically significant difference according to the NSD sides (P = 0.014). Conclusions:The study shows that the lateral lamella-cribriform plate angle increases as the cribriform plate depth increases. This result suggests that it may moderate the risk during endoscopic sinus surgery. Also, according to the nasal septum deviation sides, the dimensions of the olfactory fossa did not change significantly, except for the lateral lamella-cribriform plate angle.

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Section: Discussionsupporting

confidence: 90%

Section: Discussioncontrasting

confidence: 86%

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Radiological Evaluation of Olfactory Fossa with Cone-Beam Computed Tomography

Keşkek¹,

Aytuğar

2021

JOMR

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“…There was also no significant difference between sex and age and the depths of the right and left-sided olfactory fossa. [29] Yenigun et al [13] developed a new classification in addition to the Keros classification for the ethmoid roof based on Souza et al [21] 400 26.3 73.3 0.5 Jang et al [22] 205 30.5 69.5 none Anderhuber et al [19] 272 14.2 70.6 15.2 Nitinavakarn et al [18] 88 11.9 68.8 19.3 Adeel et al [17] 77 29.9 49.4 20.8 Basak et al [20] 64 9 53 38 Babu et al [9] 1200 visualization of the anterior ethmoidal artery, analyzing its relationship with neighboring structures in coronal, axial and sagittal CT images, evaluating its relationship with the ethmoid roof. The Keros classification used to measure lateral depth has been modified to measure the anteroposterior length of the cribriform plate on the ethmoid roof.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of olfactory fossa anatomy by computed tomography and the place of Keros classification in functional endoscopic sinus surgery

Karatay¹

2021

South Clin Ist Euras

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Functional endoscopic sinus surgery (FESS) is a frequently used treatment method, and it is important to know the anatomy of the paranasal sinuses, olfactory fossa and adjacent anatomical structures during surgery. Paranasal sinus computed tomography (CT) is a frequently used imaging method in the evaluation of the paranasal sinuses, nasal cavity and nasopharynx. Our study aims to determine Keros types and their incidence by retrospectively evaluating the depth of the olfactory fossa in our population according to the Keros classification on paranasal sinus CT images.Methods: In this study, the images of the patients who were directed by the otorhinolaryngology clinic and who underwent non-contrast paranasal sinus CT examination in the Radiology clinic between December 2018 and June 2019 were evaluated retrospectively. As a result, 522 patients between the ages of 18 and 87 were included in our study. Results:The average depth of the total 1044 olfactory fossa (OF) examined was 4.89 mm with a standard deviation (SD) calculated of ±2.79. Statistically, a significant difference was found between males and females in mean OF depth (p<0.001). According to Keros classification, 322 sides (30.85%) had type 1, 697 sides (66.75%), type 2 and 25 sides (2.4%) had type 3 in 1044 olfactory fossa. To our knowledge, this study has the largest case series for the olfactory fossa in our country, and the data were obtained in a tertiary health center. Conclusion:The routine use of Keros classification for the left and right side in paranasal sinus CT reporting will help minimize surgical complications by providing valuable contributions to the surgical branches related to the anatomy of this region.

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“…Asymmetry in the depth of the cribriform plate was seen in 33 [1,3,9,13,25,30]. No significant difference is reported in the distribution of Keros type between the left and right sides in some studies [12,13,24].…”

Section: Discussionmentioning

confidence: 94%

CBCT Assessment of Ethmoid Roof Variations through Keros, Gera, and TMS Classifications

Mahdian

Kheir

2022

International Journal of Otolaryngology

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Background. This study is designed to assess the variations of the ethmoid roof through the Keros, Gera, and Thailand-Malaysia-Singapore (TMS) classifications by means of Cone-Beam Computed Tomography (CBCT). Materials and Methods. 372 CBCT scans were reviewed. The depth of the olfactory fossa (OF) was defined by the height of the lateral lamella (LL). The degree of the angle formed by the LL and the continuation of the horizontal plane passing through the cribriform plate was calculated. The risk of injury to the skull base was assessed by TMS classification. Results. The distribution of Keros types 1, 2, and 3 was 20.43%, 66.26%, and 13.31%, respectively. No significant difference was seen in the Keros classification among males and females, and asymmetry in the depth of the cribriform plate was seen in 33.3% of patients. 29.57% of the cases had type I, 61.42% had type II, and 9.01% had type III of Gera classification. 33.9% of the patients had asymmetry in the Gera classification. There was not significant difference in the Gera classification among males and females. 95.43%, 4.17%, and 0.40% of patients were of types 1, 2, and 3 of TMS classification, respectively. Conclusion. The most prevalent variations of the ethmoid roof were Keros type II, Gera type II, and TMS type 1. Although the prevalence of the dangerous types (Keros type 3, Gera type III, and TMS type 3) was low, preoperative assessment is essential in reducing surgical complications. CBCT is beneficial in evaluating these variations due to its low radiation dose.

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Cone Beam Computed Tomography-Based Anatomical Assessment of the Olfactory Fossa

Cited by 13 publications

References 27 publications

Radiological Evaluation of Olfactory Fossa with Cone-Beam Computed Tomography

Radiological Evaluation of Olfactory Fossa with Cone-Beam Computed Tomography

Evaluation of olfactory fossa anatomy by computed tomography and the place of Keros classification in functional endoscopic sinus surgery

CBCT Assessment of Ethmoid Roof Variations through Keros, Gera, and TMS Classifications

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