Evaluation of the Relationship Between Crista Galli Classifications Using Cone-Beam Computed Tomography

Objective: To evaluate the relationships between different crista galli (CG) classification systems using cone-beam computed tomography (CBCT) images.Methods: This retrospective observational study included 150 CBCT scans (75 males, 75 females; age range: 8–84 years). CG morphology was classified as teardrop, tubular, or ossified. The depth of the olfactory fossa was assessed using the Keros classification, and the vertical position of the CG relative to the lamina cribrosa was evaluated according to the Hajiioannou classification. The presence of CG pneumatization (CG-P) was also recorded. All images were independently evaluated by two experienced oral and maxillofacial radiologists. Associations between classification systems, sex, and age were analyzed using chi-square and Fisher’s exact tests (p < .05).Results: The tubular CG morphology was the most common type (60.7%). Keros Type II (41.3%) and Hajiioannou Type II (50.7%) were the most frequently observed categories. Significant associations were found between CG morphology and Keros classification (p < .05), as well as between Keros and Hajiioannou classifications (p < .05). Ossified CG morphology was observed more frequently in Keros Type I cases. CG-P was present in 10% of cases and showed a significantly higher prevalence in males (p < .05), while no significant associations were observed with age or other classification systems (p > .05).Conclusion: CG morphology, olfactory fossa depth, and vertical CG position demonstrate statistically significant but weak associations rather than representing independent anatomical features. Integrated evaluation of multiple CG classification systems using CBCT may enhance radiological assessment and support safer surgical planning in the anterior skull base region.