Evidence map›Paper›PMID 41543618›Full record

SynthesisNeurosurgical review2026

A systematic review with meta-analysis of the olfactory fossa anatomy: Implications for anterior skull base approaches.

George Triantafyllou, Ibrahim Alzir, Nektaria Karangeli, Panagiotis Papadopoulos-Manolarakis, Juan Jose Valenzuela-Fuenzalida, Rǎzvan Costin Tudose, Mugurel Constantin Rusu, Alexandros Samolis, Maria Piagkou

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Neurosurgical review, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

George TriantafyllouDepartment of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias str, Goudi, Athens, 11527, Greece.
Ibrahim AlzirDepartment of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias str, Goudi, Athens, 11527, Greece.
Nektaria KarangeliDepartment of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias str, Goudi, Athens, 11527, Greece.
Panagiotis Papadopoulos-ManolarakisDepartment of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias str, Goudi, Athens, 11527, Greece.
Juan Jose Valenzuela-FuenzalidaDepartamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago, 8370146, Chile.
Rǎzvan Costin TudoseDivision of Anatomy, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, Department 1, Bucharest, Romania.
Mugurel Constantin RusuDivision of Anatomy, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, Department 1, Bucharest, Romania.
Alexandros SamolisDepartment of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias str, Goudi, Athens, 11527, Greece.
Maria PiagkouDepartment of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias str, Goudi, Athens, 11527, Greece. mapian@med.uoa.gr.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe anterior cranial fossa, and specifically the olfactory fossa (OF), is a region of critical importance in skull base surgery due to its complex and variable anatomy.

methodsThis systematic review and meta-analysis aimed to evaluate the depth of the OF based on the Keros (1962) classification system and to estimate the pooled prevalence of each type.

resultsA total of 40 imaging-based studies involving 17,078 skull sides were included. The pooled mean OF depth was 4.99 mm, corresponding to Keros type II, which was also the most common type with a prevalence of 66.13%, followed by type I at 22.50% and type III at 9.15%. Anatomical variation was influenced by geographical distribution, imaging modality, and age group.

conclusionsThe findings underscore the need for thorough preoperative imaging, as the identification of OF depth, symmetry, and surrounding anatomical features is essential for safe endoscopic and transcranial approaches. The study emphasizes the relevance of incorporating evidence-based anatomical knowledge into surgical planning to minimize the risk of complications such as cerebrospinal fluid leakage and intracranial injury.

Indexed as

Cranial Fossa, AnteriorNeurosurgical ProceduresSkull BaseHumansDepthKeros classificationOlfactory fossaSkull base surgeryVariation

Identifiers

PMID41543618

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.