CONCLUSION: A cone beam tomography (CBT) examination of the olfactory area with its different variants allows development of an individual anatomical-radiological risk profile of the ethmoid and the identification of so-called 'dangerous ethmoids.' OBJECTIVE: Preoperative imaging performed with high-resolution CBT is imperative for analysis of the risk of injuring the olfactory fossa during sinus surgery. This study aimed to analyze the relevant parameters. METHODS: This was a retrospective, single-center study of 141 patients. The Accu-I-Tomo F17 was used. Keros type, the point of the anterior ethmoid artery, and the angle between the lateral lamella and the cribriform plate (α(lc)) were evaluated. RESULTS: The Keros types were distributed as follows: type I, 13% (α(lc): 131°); type II, 64% (α(lc): 116°); type III, 23% (α(lc): 108°) (p < 0.001). The angle of the olfactory fossa and the position of the anterior ethmoid artery (free course: α(lc)=112° vs integrated into the skull base: α(lc)= 120°) was significantly different. DISCUSSION: Surgical procedures in Keros type III where the height of the lateral lamella is much longer than in type II or type I, with an angle of nearly 107° between the lateral lamella and the cribriform plate, are expected to be safer in comparison with Keros type II with 116° and Keros type I with 131°.
CONCLUSION: A cone beam tomography (CBT) examination of the olfactory area with its different variants allows development of an individual anatomical-radiological risk profile of the ethmoid and the identification of so-called 'dangerous ethmoids.' OBJECTIVE: Preoperative imaging performed with high-resolution CBT is imperative for analysis of the risk of injuring the olfactory fossa during sinus surgery. This study aimed to analyze the relevant parameters. METHODS: This was a retrospective, single-center study of 141 patients. The Accu-I-Tomo F17 was used. Keros type, the point of the anterior ethmoid artery, and the angle between the lateral lamella and the cribriform plate (α(lc)) were evaluated. RESULTS: The Keros types were distributed as follows: type I, 13% (α(lc): 131°); type II, 64% (α(lc): 116°); type III, 23% (α(lc): 108°) (p < 0.001). The angle of the olfactory fossa and the position of the anterior ethmoid artery (free course: α(lc)=112° vs integrated into the skull base: α(lc)= 120°) was significantly different. DISCUSSION: Surgical procedures in Keros type III where the height of the lateral lamella is much longer than in type II or type I, with an angle of nearly 107° between the lateral lamella and the cribriform plate, are expected to be safer in comparison with Keros type II with 116° and Keros type I with 131°.
Authors: J Demeslay; S Vergez; E Serrano; P Chaynes; P Cantet; B Chaput; G de Bonnecaze Journal: Surg Radiol Anat Date: 2015-08-04 Impact factor: 1.246
Authors: C Güldner; S Wiegand; R Weiss; S Bien; A Sesterhenn; A Teymoortash; I Diogo Journal: Eur Arch Otorhinolaryngol Date: 2011-07-30 Impact factor: 2.503
Authors: C Güldner; A Ningo; J Voigt; I Diogo; J Heinrichs; R Weber; T Wilhelm; M Fiebich Journal: Eur Arch Otorhinolaryngol Date: 2012-09-18 Impact factor: 2.503
Authors: Christian Güldner; Julia Heinrichs; Rainer Weiß; Annette Paula Zimmermann; Benjamin Dassinger; Siegfried Bien; Jochen Alfred Werner; Isabell Diogo Journal: Eur J Med Res Date: 2013-09-03 Impact factor: 2.175