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

Abstract

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.

Variation in Internal Carotid Artery Protrusion and Dehiscence in a Subset of Karachi Population

“…It was conducted at Department of Radiology, Ziauddin University, after the approval from ethics review committee. (14) Patients without any sphenoid sinus abnormality or adjacent structures coming for brain and head CT scan were part of this study. 16 slice Toshiba Alexion CT scanner was used to perform the scans.…”

Evaluation of the Olfactory Fossa With Computed Tomography for Endoscopic Surgery

“…Elwany et al (18) reported that type 2 OF was the most common type in males, while type 1 was most common in females. Murthy and Santosh (29) and Abdulhadi et al (31) evaluated CT images of patients undergoing FESS and reported type 2 and type 1 as the most frequent types, respectively.In contrast, Gauba et al (32) reported that type 3 was slightly high. Babu et al (25) reported that the mean OF depths on the right and left sides were 5.27 mm and 5.25 mm, respectively.…”