Abstract
Introduction: Computed tomogram (CT) of nose and paranasal sinuses provides the detailed knowledge of depth of olfactory fossa as per Keros' classification, which is important in endoscopic sinus surgery.
 Objective: To analyze the types and frequency of depth of olfactory fossa in Nepalese population.
 Methodology: This was a longitudinal study conducted from 1 May to 30 August 2018. Coronal CT scans of nose and paranasal sinuses were taken for analysis of olfactory fossa depth. The landmarks like infraorbital foramen, point of articulation of medial ethmoidal roof with lateral lamella of cribriform plate (MERP) and lowest point on the cribriform plate (CP) were taken. The lateral lamella of cribriform plate (LLCP) was calculated by subtracting CP height from MERP height (MERP-CP = LLCP).
 Results: There were total 101 patients included. The distribution of age was 33.72 ± 15.15 years. The keros' type I was the most common (86.1%). Regarding the olfactory fossa depth, right side was deeper in male whereas in females, the left side was deeper, but overall right side was deeper in 52(51.5%) patients.
 Conclusions: Type I Keros' was the most common whereas type III Keros' was the least common. A deep olfactory fossa is more common on right.
Highlights
For the endoscopic sinus surgery the detailed anatomical knowledge of nose and paranasal sinus is important
There are not many studies done in Nepal regarding olfactory fossa depth, this study explores the varia ons of olfactory fossa depth which will help during endoscopic sinus surgery
Regarding the depth of the olfactory fossa, right side was deeper in males whereas the le side was deeper in females, but overall right side was deeper 52(51.5%) as shown in table 3
Summary
For the endoscopic sinus surgery the detailed anatomical knowledge of nose and paranasal sinus is important. The knowledge is mainly gained by the computed tomogram of nose and paranasal sinuses. Though there are several other important surgical landmarks, the landmark of olfactory fossa is very important during sinus surgeries to avoid iatrogenic injury to anterior skull base. The olfactory fossa is occupied by the olfactory nerve and bulb. It lies in the most infero-medial por on of the anterior cranial fossa. The crista galli forms the longitudinal limb above the horizontal limb and the perpendicular plate lies below it.[1]
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