<p>The lateral lamella of the cribriform plate determines the depth of the olfactory fossa and represents the most vulnerable region of the anterior skull base during functional endoscopic sinus surgery. Its angulation with the medial lamella adds further to the risk. This study aims to assess the correlation between olfactory fossa depth and the angulation between the lateral and medial lamella of the cribriform plate on computed tomography. A retrospective review of 150 computed tomography scans of the paranasal sinuses from patients aged ≥ 18 years was performed. Olfactory fossa depth and lateral-medial lamellar articulation angle were measured bilaterally. Olfactory fossa depth was classified according to Keros’ classification and lamellar angulation according to Gera’s classification. The mean olfactory fossa depth was 4.28 ± 1.17&#xa0;mm on the right and 4.44 ± 1.05&#xa0;mm on the left, with the left side being significantly deeper (<i>p</i> = 0.01). The mean lamellar angle measured 69.1 ± 11.4° on the right and 70.1 ± 11.2° on the left, with no significant side difference (<i>p</i> = 0.206). Keros type 2 (73.3%) and Gera class II (81%) configurations were most prevalent. A weak positive correlation was observed between olfactory fossa depth and lamellar angulation on both sides (<i>r</i> ≈ 0.29). Olfactory fossa depth and lateral–medial lamellar angulation demonstrate a weak correlation and appear largely independent. Both parameters should be assessed individually on preoperative imaging to better evaluate anterior skull base injury risk.</p>

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Olfactory Fossa Depth and Lateral-medial Lamellar Angulation in Anterior Skull Base Injury Risk Assessment. Do They Correlate? a Computed Tomography-based Study

  • Urmila Gurung,
  • Kripa Dongol,
  • Sharma Paudel,
  • Prajwal Dhakal,
  • Manisha Paneru

摘要

The lateral lamella of the cribriform plate determines the depth of the olfactory fossa and represents the most vulnerable region of the anterior skull base during functional endoscopic sinus surgery. Its angulation with the medial lamella adds further to the risk. This study aims to assess the correlation between olfactory fossa depth and the angulation between the lateral and medial lamella of the cribriform plate on computed tomography. A retrospective review of 150 computed tomography scans of the paranasal sinuses from patients aged ≥ 18 years was performed. Olfactory fossa depth and lateral-medial lamellar articulation angle were measured bilaterally. Olfactory fossa depth was classified according to Keros’ classification and lamellar angulation according to Gera’s classification. The mean olfactory fossa depth was 4.28 ± 1.17 mm on the right and 4.44 ± 1.05 mm on the left, with the left side being significantly deeper (p = 0.01). The mean lamellar angle measured 69.1 ± 11.4° on the right and 70.1 ± 11.2° on the left, with no significant side difference (p = 0.206). Keros type 2 (73.3%) and Gera class II (81%) configurations were most prevalent. A weak positive correlation was observed between olfactory fossa depth and lamellar angulation on both sides (r ≈ 0.29). Olfactory fossa depth and lateral–medial lamellar angulation demonstrate a weak correlation and appear largely independent. Both parameters should be assessed individually on preoperative imaging to better evaluate anterior skull base injury risk.