ANATOMICAL VARIABILITY OF THE OLFACTORY FOSSA BASED ON KEROS CLASSIFICATION IN AN ADULT POPULATION
Main Article Content
Keywords
..
Abstract
The olfactory fossa is one of the regions of the anterior skull base with the most anatomical diversity. Its depth, which is determined by the lateral lamella of the cribriform plate, is commonly classified using the Keros technique. Understanding this diversity becomes essential for accurate anatomical analysis and population-based assessment. In the present study 140 adult patients who had non-contrast paranasal sinus computed tomography at a tertiary care facility were included. On coronal CT scans, the depth of the olfactory fossa was assessed at its deepest point. The Keros categorization was used on both sides. SPSS was used for the statistical analysis, with a significance level of p < 0.05.The most common configuration was Keros Type II, which was followed by Type I and Type III. The bilateral symmetry was seen in the olfactory fossa, and there was no statistically significant difference between the two sides. A substantial variation in depth was noted on the left side, although gender-wise analysis revealed no significant correlation with Keros categorization. The study's objective is to assess the olfactory fossa's anatomical diversity in an adult population using Keros classification and related morphometric measures. In the adult population under study, Keros Type II is predominant. Regular side-based assessment with coronal CT improves knowledge of anterior skull base variability and yields useful morphometric data.
References
2. Souza SA, Souza M, Idagawa M. Computed tomography assessment of ethmoid roof: a relevant region at risk in endoscopic sinus surgery. Radiol Bras. 2008;41:143-e147.
3. Keros P. On the practical value of differences in the level of the lamina cribrosa of the ethmoid. Z Laryngol Rhinol Otol. 1962;41:809–13.
4. Costa ALF, Paixão AK, Gonçalves BC, Ogawa CM, Martinelli T, Maeda FA, et al. Cone beam computed tomography-based anatomical assessment of the olfactory Fossa. Int J Dent [Internet]. 2019;2019:4134260. Available from: http://dx.doi.org/10.1155/2019/4134260
5. Pawar A, Konde S, Bhole P. Assessment of depth of olfactory fossa in pre-functional endoscopic sinus surgery computed tomography scan of paranasal sinuses. Int J Otorhinolaryngol Head Neck Surg [Internet]. 2017;4(1):83. Available from: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20174663
6. Güler C, Uysal IÖ, Polat K, Salk I, Müderris T, Koşar MI. Analysis of ethmoid roof and skull base with coronal section paranasal sinus computed tomography. J Craniofac Surg [Internet]. 2012;23(5):1460–4. Available from: http://dx.doi.org/10.1097/SCS.0b013e31825755b2
7. Salroo IN, Dar NH, Yousuf A, Lone KS. Computerised tomographic profile of ethmoid roof on basis of keros classification among ethnic Kashmiri’s. Int J Otorhinolaryngol Head Neck Surg [Internet]. 2016;2(1):1. Available from: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20151134
8. Kaplanoglu H, Kaplanoglu V, Dilli A, Toprak U, Hekimoğlu B. An analysis of the anatomic variations of the paranasal sinuses and ethmoid roof using computed tomography. Eurasian J Med [Internet]. 2013;45(2):115–25. Available from: http://dx.doi.org/10.5152/eajm.2013.23
9. Savvateeva DM, Güldner C, Murthum T, Bien S, Teymoortash A, Werner JA, et al. Digital volume tomography (DVT) measurements of the olfactory cleft and olfactory fossa. Acta Otolaryngol [Internet]. 2010;130(3):398–404. Available from: http://dx.doi.org/10.3109/00016480903283741
10. Lang J. Klinische Anatomie der Nase, Nasenho¨hle und Nebenho¨hlen. Thieme Stuttgart. 1998:23-e27.
11. Meloni F, Mini R, Rovasio S, Stomeo F, Teatini GP. Anatomic variations of surgical importance in ethmoid labyrinth and sphenoid sinus. A study of radiological anatomy. Surg Radiol Anat [Internet]. 1992;14(1):65–70. Available from: http://dx.doi.org/10.1007/bf01628046
12. Hoang JK, Eastwood JD, Tebbit CL, Glastonbury CM. Multiplanar sinus CT: a systematic approach to imaging before functional endoscopic sinus surgery. AJR Am J Roentgenol [Internet]. 2010;194(6):W527-36. Available from: http://dx.doi.org/10.2214/AJR.09.3584
13. Şahan MH, Inal M, Muluk NB, Şimşek G. Cribriform plate, Crista Galli, olfactory Fossa and Septal Deviation. Curr Med Imaging Rev [Internet]. 2019;15(3):319–25. Available from: http://dx.doi.org/10.2174/1573405614666180314150237
14. Almushayti ZA, Almutairi AN, Almushayti MA, Alzeadi HS, Alfadhel EA, Alsamani AN, et al. Alfadhel Sr EA. Evaluation of the Keros classification of olfactory fossa by CT scan in Qassim region. Cureus. 2022;14(2).
15. Erdem G, Erdem T, Miman MC. A radiological anatomy of the cribriform plate compared with constant structures. Rhinology. 2004;42:225-e229.
16. Başak S, Karaman CZ, Akdilli A, Mutlu C, Odabaşi O, Erpek G. Evaluation of some important anatomical variations and dangerous areas of the paranasal sinuses by CT for safer endonasal surgery. Rhinology. 1998;36(4):162–7.

