Configuration of ethmoid roof in children aged 0 to 14 years.

Background: Knowledge of the unique anatomy of the nose, paranasal sinuses and skull base, particular concerning dangerously low positioned or deep ly ing cribriform plates is most important, as functional endoscopic sinus sur gery has become an increasingly popular procedure for the management of ped iatric sinus disease. Objectives and Methods: in addition to Keros who stud ied the ethmoidal roof and cribriform plate in 450 adult specimen and divid ed them into 3 groups, retrospective analysis in 272 patients between 0 and 14 years was performed by means of coronal CT scans of the paranasal sinus es with a slice thickness of 2 mm. Measurements were carried out in the fro ntal, middle and dorsal section of the ethmoid. Results: The depth and widt h of the fossa olfactoria were significantly less in patients aged 0-12 mon ths than in other age groups (p < 0.001). Among the other age groups, begin ning at 2 years no differences were found: 14.2% presented with type I acco rding to Keros, 70.6% with Keros II and 15.2% with Keros III. The prevalenc e of asymmetric position of the ethmoidal roof was 15% (41 patients). The h eight of the ethmoidal sinuses consistently increased over the years from 5 -7 mm to 15-20 mm. Conclusion: The current data may serve as a reference fo r evaluation of normal and abnormal development of the roof of the ethmoid and may be of great value in diagnostic and therapeutic management of pedia tric sinus disease. Our data obviously show that the classification into th e 3 types of positions of the ethmoid roof and cribriform plate according t o Keros is possible in children from the second year of life.