Relationship between vidian canal type, Keros classification, and the sphenovomer suture-philtrum distance: a computed tomography-based morphometric study
Mehmet Ali Say1, Murat Yücel2, Osman Kındır3
1Department of Otorhinolaryngology, Faculty of Medicine, Yalova University, Yalova, Turkiye. mehmet.say@yalova.edu.tr.
Background:
The vidian canal and the Keros classification are well-established computed tomography (CT) landmarks for preoperative skull base assessment. However, their anatomical relationship and their association with the sphenovomer suture-philtrum (SVS-philtrum) distance have not been comprehensively investigated. This study aimed to evaluate the relationship between Keros classification and vidian canal configuration and to determine whether the sphenovomer suture-philtrum distance is associated with either parameter.
Materials And Methods:
This retrospective cross-sectional study included 348 adults who underwent paranasal sinus CT. Vidian canal configuration and Keros classification were assessed separately for the right and left sides, and the SVS-philtrum distance was measured on multiplanar CT images. Associations between ipsilateral Keros classification and vidian canal type were evaluated separately for each side. Age- and sex-adjusted general linear models were used to evaluate the associations of Keros classification and vidian canal type with SVS-philtrum distance.
Results:
No statistically significant association was identified between ipsilateral Keros classification and vidian canal type on either the right (p = 0.167) or left (p = 0.529) side. In age- and sex-adjusted models, neither right-sided Keros classification (p = 0.612) nor right-sided vidian canal type (p = 0.257) was significantly associated with SVS-philtrum distance. Similarly, no significant associations were observed for left-sided Keros classification (p = 0.199) or left-sided vidian canal type (p = 0.230). SVS-philtrum distance was significantly greater in men than in women (71.80 ± 4.42 mm vs 65.28 ± 3.91 mm, p < 0.001).
Conclusions:
No statistically significant associations were detected between ipsilateral Keros classification and vidian canal type or between SVS-philtrum distance and the evaluated anatomical classifications. These findings persisted after adjustment for age and sex and suggest that strong relationships among these parameters were not evident in the present cohort. However, the absence of statistical significance should not be interpreted as evidence of anatomical independence.
