Olfactory Fossa and New Angle Measurements: Lateral Lamella-Cribriform Plate Angle

Asal, Neşe; Muluk, Nuray Bayar; İnal, Mikail; Şahan, Mehmet Hamdi; Doğan, Adil; Arıkan, Osman Kürşat

doi:10.1097/scs.0000000000005848

Cited by 12 publications

(15 citation statements)

References 19 publications

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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%

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%

Radiological Evaluation of Olfactory Fossa with Cone-Beam Computed Tomography

Keşkek¹,

Aytuğar

2021

JOMR

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“…Asal et al reported that the relationship of lower lateral lamella cribriform plate angles with Keros III would be more dangerous during ESS because of increased risk of trauma to the lateral lamella and intracranial penetration. 26 No formal analysis was performed but our data suggests a similar observation, there is hypothesis that lesser the angle of the lateral lamella, more of the skull base covered by thin bone. 27 This is important to consider in patients with low Keros scores.…”

Section: Discussionsupporting

confidence: 69%

“…Asal et al reported that the relationship of lower lateral lamella cribriform plate angles with Keros III would be more dangerous during ESS because of increased risk of trauma to the lateral lamella and intracranial penetration. 26 We believe this is not clinically significant when considering iatrogenic injury to the cribriform, as the depth and narrowness of the OF will not change greatly within that range. Asal et al reported that the relationship of lower lateral lamella cribriform plate angles with Keros III would be more dangerous during ESS because of increased risk of trauma to the lateral lamella and intracranial penetration.…”

Section: Discussionmentioning

confidence: 96%

Anatomical Parameters and Growth of the Pediatric Skull Base: Endonasal Access Implications

Chen

Pool

Slonimsky

et al. 2022

J Neurol Surg B Skull Base

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Objectives: Endoscopic endonasal anterior skull base surgery has expanding use in the pediatric population, but the anatomy of pediatric patients can lead to limitations. This study aims to characterize the important anatomical implications of the pediatric skull base using computed tomography (CT) scans. Design: Retrospective analysis Setting: Tertiary academic medical center Participants: 506 patients aged 0-18 who had undergone maxillofacial and or head CTs between 2009-2016. Methods: Measurements included piriform aperture width, nare to sella distance (NSD), sphenoid pneumatization, olfactory fossa depth, lateral lamella cribriform plate angles, and intercarotid distances (ICD) at the superior clivus and cavernous sinus. These patients were then subdivided into 3 age groups adjusting for sex. ANCOVA models were fit comparing between all age groups and by sex. Results: Piriform aperture width, NSD, sphenoid sinus pneumatization as measured using lateral aeration and anterior sellar wall thickness, olfactory fossa depth, and ICD at the cavernous sinus was significantly different among all age groups (P<0.0001). Our results show that mean piriform aperture width increased with each age group. The mean olfactory fossa depth also had consistent age dependent growth. In addition, ICD at the cavernous sinus showed age dependent changes. When comparing by sexes, females consistently showed smaller measurements. Conclusion: The process of skull base development is age and sex dependent. During preoperative evaluation of pediatric patients for skull base surgery piriform aperture width, sphenoid pneumatization in both the anterior posterior and lateral directions, and ICD at the cavernous sinus should be carefully reviewed.

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“…This was in accordance with a past study, who also concluded that type olfactory fossa was the most frequently found in 70% of the 450 skull specimens they studied. 17 The frequency of type-I and type-II was 12% and 18%, respectively. The findings of Elwany et al also corresponded with our results which found that type-II olfactory fossa was most frequently found in the Egyptian population being present in 56.8% of the cases while type-I was present in 42.5% of the cases.…”

Section: Discussionmentioning

confidence: 95%

Anatomical Variation of Olfactory Fossa on Computed Tomography of Paranasal Sinuses

Shahid

Mahmood²,

Ullah³

et al. 2023

PAFMJ

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Objective: To determine the frequency of anatomical variation of olfactory fossa among the adult Pakistani population by Keros classification on computed tomography (CT) of paranasal sinuses. Study Design: Cross-sectional study Place and Duration of Study: Department of Radiology, Combined Military Hospital, Rawalpindi Pakistan, from May 2019 to Mar 2020. Methodology: A total of 65 patients of either gender were included. Patients with previous trauma or surgery of the skull base or paranasal sinuses, malignant diseases of the sinuses and congenital anomalies were excluded. All the included patients in the study underwent CT paranasal sinuses. Measurements of the olfactory fossae followed by grouping as per Kero’s classification were done, and CT findings were recorded. Results: The patients included in the study ranged from 18 to 65 years, with a mean age of 33.09±10.86 years and 72.3% of patients 18 to 40 years of age. Of 65 patients, 36(55.4%) were males, and 29(44.6%) were females. The mean CT depth of the olfactory fossa was 6.34 ±4.03mm. Type-I olfactory fossa by Keros classification was found in 17(26.2%), Type-II in 35(53.8%) and Type-III in 13(20%) of patients. Conclusion: This study concluded that Keros Type-II is the most common anatomical variation of olfactory fossa among the adult Pakistani population on CT of paranasal sinuses with an intermsediate risk of intracranial complications during endoscopic sinus surgery involving this region.

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Olfactory Fossa and New Angle Measurements: Lateral Lamella-Cribriform Plate Angle

Cited by 12 publications

References 19 publications

Radiological Evaluation of Olfactory Fossa with Cone-Beam Computed Tomography

Radiological Evaluation of Olfactory Fossa with Cone-Beam Computed Tomography

Anatomical Parameters and Growth of the Pediatric Skull Base: Endonasal Access Implications

Anatomical Variation of Olfactory Fossa on Computed Tomography of Paranasal Sinuses

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