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Keros classification of olfactory fossa

Dr Derek Smith ◉ and Dr Mark Holland et al.

The Keros classification is a method of classifying the depth of the olfactory fossa.

The ethmoid labyrinth is covered by the fovea ethmoidalis of the frontal bone and separates the ethmoidal cells from the anterior cranial fossa.

The very thin, horizontal cribriform plate (lamina cribrosa) of the ethmoid bone is bounded laterally by the vertical lateral lamella. The lateral lamella joins the cribriform plate to the fovea ethmoidalis.

In adults, the olfactory recess is a variable depression in the cribriform plate that medially is bounded by the perpendicular plate and laterally by the lateral lamella. It contains olfactory nerves and a small artery.

The depth of the olfactory fossa is determined by the height of the lateral lamella of the cribriform plate, which can be classified into three categories:

type 1: has a depth of 1-3 mm (26.3% of population)
type 2: has a depth of 4-7 mm (73.3% of population)
type 3: has a depth of 8-16 mm (0.5% of population)

The type 3 essentially exposes more of the very thin cribriform plate to potential damage from trauma, tumor erosion, CSF erosion (in benign intracranial hypertension) and local nasal surgery/orbital decompression ².

Thin bone in the skull base, especially the cribriform plate, is susceptible to erosion, encephalomeningocele herniation and CSF leaks

The most common sites of erosion or defects in the skull base are

cribriform plate (51%)
sphenoid lateral pterygoid recess (31%)
ethmoid roof (8%)
perisella
inferolateral or pterygoid recesses

History and etymology

This classification was described in 1962 ¹ by Predrag Keros (1933-2018) ³, a Croatian physician and later Professor of Medicine at the University of Zagreb.

See also

functional endoscopic sinus surgery (FESS)

References

Anatomy: Head and neck

Article information

rID: 19069

System: Head & Neck

Section: Anatomy

Tag: olfactory fossa, keros type, csf leak, refs

Synonyms or Alternate Spellings:

Keros classification of the olfactory fossa
Keros classification

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Cases and figures

Figure 1: annotated image - olfactory fossaFigure 1: annotated image - olfactory fossa

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Figure 2: annotated image - olfactory fossaFigure 2: annotated image - olfactory fossa

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Case 1: type 1 Case 1: type 1

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Case 2: type 2 Case 2: type 2

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