DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20151134

Computerised tomographic profile of ethmoid roof on basis of keros classification among ethnic Kashmiri’s

Imran Nazir Salroo, Nisar Hussain Dar, Aamir Yousuf, Kousar Sideeq Lone

Abstract


Background: The purpose of this study was to evaluate the ethmoid roof on computerized tomography of nose and paranasal sinuses of Kashmiri people and distribute them on basis of KEROS classification.

Methods: Cross sectional descriptive study, the randomly selected paranasal sinus computed tomography (PNS CT) scans coronal cuts .Total of One hundred PNS CT scans done at the SMHS Hospital from April 2015 to September 2015 were reviewed, and selected for study. The bilateral heights of the lateral lamellae of the cribriform plate were obtained, independently coded, and classified according to keros.

Results: The mean height of the lateral lamella among Kashmir’s was seen to be 5.08mm and 29% of patient’s CT PNS were classified as Keros I, 61% were classified as Keros II and 10% were classified as Keros III. There was significant difference in the distribution of Keros classification between the right and left lateral lamella. There was no significant difference in the height of the lateral lamella (t-test: p=0.98 on right side & p =0.89 on left side) and the distribution of Keros classification (Fisher’s Exact test: p = 0.823) among younger (1-14 year) and older (>14 year) Kashmiri age groups. There is significant difference in the height (t-test: p=0.03 on right side and p=0.03 on left side) and the distribution of Keros classification is statistically insignificant (Fishers Exact Test: p=0.11) between Kashmiri females and males.

Conclusions: Preoperative assessment of ethmoid roof anatomy and keros level is mandatory for alerting the surgeon of the potential iatrogenic injury during endoscopic sinus surgeries to minimize the grave complications during ESS.


Keywords


Tomography, Ethmoid roof, KEROS, Kashmir

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References


O’malley BB. head and neck imaging. In: atlas of clinical oncology. 2003:57-75.

Bista M, Maharjan M, Kafle P, Shrestha S, Kc T, Patron V, et al. Lateral Lamella of the Cribriform Plate. Head Neck. 2014;1(3):285-9.

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.

Paber JE, Salvador M, Villarta R. Radiographic analysis of the ethmoid roof based on keros classification among filipinos. 2008;23(1):15-9.

Gauba V, Saleh GM. Radiological classification of anterior skull base anatomy prior to performing medial orbital wall decompression. Orbit. 2006;25:93-6.

Stammberger HR, Kennedy DW. Paranasal sinuses: anatomic terminology and nomenclature. The Anatomic Terminology Group. Ann Otol, Rhinol Laryngol. 1995;167:7-16.

Nitinavakarn B, Thanaviratananich S, Sangsilp N. Anatomical variations of the lateral nasal wall and paranasal sinuses: a CT study for endoscopic sinus surgery (ESS) in Thai patients. J Med Assoc Thai. 2005;88:763-8.

Floreani SR, Nair SB, Switajewski MC, Wormald PJ. Endoscopic anterior ethmoidal artery ligation: a cadaver study. Laryngoscope. 2006;116(7):1263-7.

Elwany S, Medanni A, Eid M, Aly A, El-Daly A. Radiological observations on the olfactory fossa and ethmoid roof J Laryngol Otol. 2010:1251-6.

Solares CA, Lee WT, Batra PS, Citardi MJ. Lateral lamella of the cribriform plate: software-enabled computed tomographic analysis and its clinical relevance in skull base surgery. Arch Otolaryngol Head Neck Surg. 2008;134(3):285-9.

Erdem G, Erdem T, Miman MC, Ozturan O. A radiological anatomic study of the cribriform plate compared with constant structures. Rhinology. 2004;42:225.

Wormald PJ. Endoscopic sinus surgery: anatomy, three dimensional reconstruction, and surgical technique. Thieme, New York, 2012.

Lebowitz RA, Terk A, Jacobs JB, Holliday RA. Asymmetry of the ethmoid roof: analysis using coronal computed tomography. Laryngoscope. 2001;111:2122-4.