ArticleScientific reports2020
A new radiological classification for the risk assessment of anterior skull base injury in endoscopic sinus surgery.
Article in Scientific reports, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed, 29 citations in OpenAlex.
- Keros-Net: a convolutional block attention module-squeeze-and-excitation-integrated hybrid learning framework for olfactory fossa depth classification.Diagnostic and interventional radiology (Ankara, Turkey) · 2026Article
- Deep learning classification of nasal anatomical variants on computed tomography for endoscopic sinus surgery.Scientific reports · 2026Article
- Anatomic Variations of the Lacrimal Sac Relative to Middle Turbinate Axilla and Skull Base in Chinese Patients with Nasolacrimal Duct Obstruction: A CT-Dacryocystography.Current medical science · 2025Article
- Computed tomography volumetric analysis of frontal sinus pneumatization and its effect on lateral lamella angle.Surgical and radiologic anatomy : SRA · 2024Article
- The Effects of Nasal Septal Deviation on Anterior Skull Base Parameters.International archives of otorhinolaryngology · 2024Article
- Photon Counting Computed Tomography for Accurate Cribriform Plate (Lamina Cribrosa) Imaging in Adult Patients.Tomography (Ann Arbor, Mich.) · 2024Article
- Relation between anterior ethmoidal artery course on computed tomography and supraorbital ethmoid cell and Keros classification.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2024Article
- Iatrogenic Cerebrospinal Fluid Leak in Endoscopic Sinus Surgery: Topographical Map and Influence of Skull Base Asymmetry.Journal of personalized medicine · 2024Article
- Computed tomographic assessment of risk of anterior skull base injury of adult patients in tertiary care centre: a cross-sectional study.Annals of medicine and surgery (2012) · 2023Article
- A comparative analysis of the CP and CG using 2D and 3D visualisation approaches.Anatomical science international · 2023Article
- Iatrogenic Skull Base Defect Accompanied by Brain Injury After Endoscopic Sinus Surgery: A Report of Two Cases.Journal of rhinology : official journal of the Korean Rhinologic Society · 2023Article
- CBCT Assessment of Ethmoid Roof Variations through Keros, Gera, and TMS Classifications.International journal of otolaryngology · 2022Article
- Radiological Evaluation of Olfactory Fossa with Cone-Beam Computed Tomography.Journal of oral & maxillofacial researchArticle
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Authors and funding
8 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Keros and Gera classifications are widely used to assess the risk of skull base injury during endoscopic sinus surgery. Although, both classifications are useful preoperatively to stratify risk of patients going for surgery, it is not practical to measure the respective lengths during surgery. In this study, we aimed to propose a new radiological classification (Thailand-Malaysia-Singapore (TMS)) to assess the anatomical risk of anterior skull base injury using the orbital floor (OF) as a reference. A total of 150 computed tomography images of paranasal sinuses (300 sides) were reviewed. The TMS classification was categorized into 3 types by measuring OF to cribriform plate and OF to ethmoid roof. Most patients were classified as TMS type 1, Keros type 2 and Gera class II, followed by patients classified as TMS type 3, Keros type 1 and Gera class 1. TMS has significant correlation with Keros classification (p < 0.05). There was no significant correlation between Keros and Gera classifications (p = 0.33) and between TMS and Gera classifications (p = 0.80). The TMS classification has potential to be used for risk assessment of skull base injury among patients undergoing ESS. It serves as an additional assessment besides the Keros and Gera classifications.
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