Crista galli in children: classification, pneumatization, dimension, and clinical relevance

Abstract

Purpose: This radiologic work aimed to display the alteration in the crista galli (CG) morphology in the pediatric population with advancing age.

Methods: This pediatric examination consisted of computed tomography images of 180 subjects (90 males / 90 females) aged 1-18 years. The width (CGW), height (CGH) and length (CGL) of CG were measured, and its morphological types were noted.

Results: CGW, CGH and CGL were measured as 4.34 ± 1.38 mm, 12.13 ± 3.36 mm and 13.03 ± 2.75 mm, respectively. CGH (p < 0.001) and CGL (p < 0.001) increased with advancing age, but CGW (p = 0.069) did not vary. Three configurations regarding morphological types of CG were observed as follows: the tear-drop type in 83 CGs (46.10%), the tubular type in 64 CGs (35.60%), and the ossified type in 33 CGs (18.30%). Three configurations related to Keros classification were determined as follows: Type 1 in 31 CGs (17.20%), Type 2 in 116 CGs (64.50%), and Type 3 in 33 CGs (18.30%). CG shape types (p = 0.455) and Keros types (p = 0.801) did not correlate with sex. CG pneumatization was found in six (3.3%) children.

Conclusions: CGL increased, but did not alter significantly after infancy period. CGW did not correlate with pediatric ages, but CGH increased with advancing age up to prepubescent period. The incidence of Type 1 decreased with advancing age, but the incidence of Types 2 and 3 increased, especially from the late childhood period. All pneumatized CGs were observed after late childhood period.

Keywords: Children; Computed tomography; Crista galli; Morphometry; Olfactory fossa; Pneumatization.