Reliability of the supraorbital ethmoid cell vs Keros classification in predicting the course of the anterior ethmoid artery

Abstract

Background:We previously showed that the supraorbital ethmoid cell (SOEC) is a reliable landmark for identifying the anterior ethmoid artery (AEA). Recent data have suggested that Keros classification is also a dependable predictor. We aim to characterize the location of the AEA and its relation to the skull base in patients with and without SOEC using the Keros classification. Methods:Retrospective radiographic evaluation of computed tomography (CT) scans of 76 patients (40 with SOEC, 36 without) was conducted. Distance of AEA from skull base and prevalence of AEA outside of the skull base were measured on each side and compared between groups using the 2-sample t test and χ 2 test, respectively. Subgroup analysis was carried out based on the Keros classification.Results: Mean distance of AEA from the skull base was 1.32 ± 1.5 mm in patients with SOEC and 0.47 ± 1.08 mm in those without (p < 0.001). Prevalence of AEA outside of the skull base was 53.8% in those with SOEC and 18.1% in those without (p < 0.001). Comparing patients with SOEC to those without, AEA was found below the skull base in 30% vs 0% of cases with Keros type 1 (p = 0.45), 58% vs 14.5% with Keros type 2 (p < 0.001), and 60% vs 50% with Keros type 3 (p = 0.72). Conclusion:The presence of SOEC is associated with a higher prevalence of the AEA coursing below the level of the skull base in all Keros types, thus placing the artery at greater risk for injury. Careful surgical planning is needed to avoid potential orbital complications. C 2019 ARS-AAOA, LLC.

Olfactory Cleft Width and Volume: Possible Risk Factors for Postinfectious Olfactory Dysfunction

“…1). 10 All measurements were performed by a single radiologist who was not able to access to demographic and clinical information of the patients.…”

Variability of the Anterior Ethmoid Artery in Endoscopic Sinus Surgery

“…His classification scheme has become widely adopted and is universally used by sinus surgeons to identify patients with skull base configurations at risk of injury during sinonasal surgery. Li et al 18 evaluated patients with and without SOECs and found an increase in the distance between the skull base and AEA with higher Keros classification. The presence of SOEC is also associated with a further increase in the distance and an increase in the prevalence of AEA descent from the skull base in all Keros types.…”

Olfactory Cleft Measurements and COVID‐19–Related Anosmia

“…The olfactory fossa depth was checked based on the position of the cribriform plate relative to the ethmoid roof based on the Keros classification. 18 …”

“…Calculated volumes were recorded in cm 3 and the average density of the total volume within the voxel was recorded in Hounsfield units ( Figure 2). The olfactory fossa depth was checked based on the position of the cribriform plate relative to the ethmoid roof based on the Keros classification 18 …”

“…The olfactory fossa depth was checked based on the position of the cribriform plate relative to the ethmoid roof based on the Keros classification. 18 Magnetic resonance imaging technique. All group 1 to 2 patients in the study had a multiparametric odor functional magnetic resonance imaging (MRI) assessment in our unit that is specialized on smell-taste disorders and has the latest technological equipment.…”