Shape Of Sella Turcica Research Articles

Retrospective analysis of size and morphology of sella turcica in different skeletal patterns in Madinah, Saudi Arabia

Introduction: Local and genetic factors influence size and shape of Sella Turcica (ST) and as such this may impact many parameters including Sella reference point for orthodontic treatment planning. Our aim was set to measure and assess ST morphology and link it with gender and different skeletal patterns. Methods: This retrospective study conducted on the lateral cephalometric radiographs of 175 patients 15 years and above attending Taibah University Dental College and Hospital between 2011 and 2017. The patients’ radiographs meeting inclusion criteria were stratified by gender and divided into three groups (Class I, II, and III) according to the skeletal classification. Length, depth and Anteroposterior (A-P) diameter of ST were measured using a cephalometric software program (Vista Dent) and the shape of ST according to established classifications in the literature. Descriptive statistics and inferential analysis (e.g. one-way analysis of variance (ANOVA) were performed. Results: The mean/SD age of the patients was 27.43±7.54. The mean/SD length, depth and A-P diameter of ST for male and females were 10.56±1.68, 7.83±1.62, 11.98±1.90, 7.00±2.58, 6.81±1.64, 10.17± 1.86, respectively. There were significant differences (p 0.05). As for ST morphology 53% of patients had normal Sella shape. While comparing Sella shape with different skeletal classes there were significant differences with circular shape 55% in class I and flat shape 53.3% in class II patients. Conclusions: Gender differences in ST size has been further confirmed in this study sample with the size significantly larger in males. Also, normal shape of ST is more common than other shape variations. This study can be used as a reference guide for future studies about ST size and morphology. Keywords: Sella turcica, Sella size, Sella morphology, Lateral cephalometric.

Relationship between sella turcica bridging and cephalometric parameters in adolescents and young adults.

Sella turcica bridging occurs with fusion or calcification of the anterior and posterior clinoid processes in the middle cranial region. This study aimed to compare the cephalometric parameters among normal shape, partial bridge, and total bridge of the sella turcica in adolescent and young adult subjects. This retrospective study was performed on the lateral cephalometric radiographs of 410 Turkish adolescent and young adult subjects. The subjects were divided into three groups: normal sella turcica shape (128 females, 32 males; mean age: 17.7 ± 1.54years), partial sella turcica bridge (129 females, 32 males; mean age: 17.8 ± 2.15years), and total sella turcica bridge (66 females, 23 males; mean age: 18.2 ± 1.82years). Thirteen angular and eight linear cephalometric measurements were performed using a cephalometric software program. The data were analyzed by one-way analysis of variance, and the Kruskal-Wallis test with the Bonferroni correction. Significant differences were found for Nperp-A distance, Nperp-Pg distance, and palatal plane-to-anterior cranial base angle among the groups (p < 0.016). There were no significant differences in the cephalometric parameters between the partial and total sella turcica bridging groups (p > 0.05). This study evaluated a large amount of data for cephalometric measurements focusing on the degree of calcification of the sella turcica in adolescent and young adult subjects. The maxilla and mandible were located in a sagittally retrusive position in the partial and total sella turcica bridge subjects compared with the normal sella turcica shape subjects.

Sella turcica variations in lateral cephalometric radiographs and their association with malocclusions

Objectives: Classification of the skeletal facial types is performed using certain reference points and planes in lateral cephalometric radiographs to plan orthodontic treatments. One of these reference points is sella turcica which is closely associated with craniofacial bone development. The aim of this study was to identify the association between the sella turcica variations and skeletal Class I, II, and III malocclusions. Methods: This study retrospectively evaluated 94 orthodontic patients (48 males and 46 females) between 14–26 years of age. Lateral cephalometric radiographs of the patients with skeletal Class I, II, and III malocclusions were classified into six groups according to sella turcica morphology: normal sella turcica, oblique anterior wall, double contour of the floor, sella turcica bridge, irregularity in the posterior part, and pyramidal shape of sella turcica. The length, depth, and diameter of sella turcica were measured. Sella turcica variations and radiographs of patients with Class I, II, and III malocclusions were compared statistically. Results: The correlation between the sella turcica variations and skeletal sagittal classification was statistically significant (p=0.017). 36.8% of the radiographs, which were classified as normal sella turcica were classified as Class I patients. There were no statistically significant differences between the skeletal Class I, II, and III malocclusions and sella turcica variations in terms of the length, depth, and diameter. Conclusion: For adequate patient referral and management, orthodontists should recognize sella turcica variations in lateral cephalometric radiographs, and these findings should arise an index of suspicion for associated pathologies, especially of the hypophyseal gland.

A cephalometric morphometric study of age- and gender-dependent shape patterns of the sella turcica

The sella turcica is an important anatomic and radiologic entity. The shape of the sella turcica varies among normal individuals and can be influenced by local factors. The normal shape of sella turcica has been categorized as circular, oval, and flat, and several variants have been described. The sella turcica increases in size with age, but there is no agreement upon significance of gender-related differences. The main objective of this study is to build up a normative database of the shape of the sella turcica in the Jordanian population with reference to age and gender. For this purpose 509 computed cephalograms: 252 males and 257 females, aged 10 to 40 years old healthy Jordanians were collected and divided into adolescent and adult age groups in both genders. Viewbox 3 software was used to determine width and height, and shape of the sella turcica was accordingly assessed. Variants of shape were also documented. Our results showed that females exhibit higher percentage of overall normal shape but lower relative percentages of oval and flat shapes, as compared with males. In contrast to males, females also show decreasing trend of normal shape as age advances. Females and males change obviously in favor of oval shape. In terms of variants, as individuals advance in age, bridging and irregular dorsum clearly predominate. In terms of width and height, significant differences were evident between adult male group on one hand and adolescent female group and adult female group on the other hand. Between age categories and within male and female groups, sella linear dimensions were significantly different between adolescent and adult age groups. The significant increase of linear parameters of sella turcica across age groups indicates that there is significant degree of growth in sella turcica across the studied age groups. However, this growth does not affect the shape of sella turcica as the shape seems to be preserved across the studied age groups. The obtained data are discussed in terms of age- and gender-related growth and degenerative bone changes.

Morphometric Analysis of Sella Turcica Using Cone Beam Computed Tomography

The purpose of this study was to assess morphological shape and morphometric analysis of the sella turcica using cone beam computed tomography (CBCT) in different planes of section (coronal and sagittal). CBCT images of 177 subjects of which 51 males and 126 females in the age group of 11 to 73 years were included in the study population. Linear dimensions which include the length, depth, diameter, and interclinoid distance were measured and the shape of sella turcica was analyzed. Sella turcica had circular morphology in 69.5% of the subjects while flattened shape of sella turcica was observed in 16.4%, oval shape of sella turcica in 14%. There was no significant difference in the all measurements of sella turcica between males and females (P > 0.05). Diameter (P < 0.01), depth (P < 0.001), length (P < 0.05), and interclinoid distance (P < 0.05) of the sella turcica differed significantly with age. The anatomical structure of sella turcica can be studied effectively in CBCT images. Linear dimensions and shape of sella turcica in the current study can be used as reference standards for further investigations.

Relationship between the morphological variation of sella turcica with age and gender: A digital radiographic study

Introduction: Sella turcica is a saddle-shaped concavity located in the middle cranial fossa of the skull. The exact dimensions of sella turcica are an important consideration in the diagnosis, prognosis, and treatment of diseases related to the pituitary gland and brain. The sella turcica size and morphology is different from person to person. Thus, obtaining any data in this regard will be a great help in detecting abnormalities within this anatomic area. Aim: The objective of this study was to find out the correlation between the morphological variations of sella turcica with age and gender. Materials and Methods: Study sample consisted of 311 cephalograms of patients with age ranging 6–40 years. The contour of the sella turcica was traced and the linear measurements – length, depth, and diameter of sella turcica – were measured according to Silverman. Results: Morphology of sella turcica appeared to be normal shape in 27.3% of the study population followed by combination (26.7%), irregular (15.8%), pyramidal (10.6%), bridge (10%), oblique anterior wall (5.5%), and double contour (4.2%). Gender-wise comparison of the linear measurement was not statistically significant. Among the linear measurement, the parameter depth and diameter were statistically significant (P < 0.001) when correlated with age. On comparison of shape of sella turcica with linear measurements, the parameter length was statistically significant (P < 0.001). Conclusion: There is no significant relationship between the linear measurements and gender. There exists a significant relationship between the mean depth and mean diameter with age. That is, as age increases, the depth and diameter increase. There is a significant relationship between the length and the different shapes of sella turcica.

A Study on the Shape of Sella Turcica

A Study on the Shape of Sella Turcica

Evaluation of Sella Turcica Shape and Dimensions in Cleft Subjects Using Cone-Beam Computed Tomography

Objective: The aim of this study was to assess the morphology of the sella turcica and measure its size in cleft and noncleft subjects. Material and Methods: Cone-beam computed tomography (CBCT) images of 54 individuals (29 males; 25 females) with cleft and 85 (22 males; 63 females) without cleft were used for this study. Syndromic patients with cleft(s) were not included because of possible additional endocrinological and/or morphological disorders. Linear measurements included length, depth, and diameter. The shape of the sella turcica was analyzed in the cleft and noncleft groups. An independent t test was conducted to evaluate differences between genders and groups. One-way ANOVA was used to compare age groups. Results: The length (p < 0.001) of the sella turcica was smaller in noncleft subjects than in cleft subjects. Diameter (p = 0.014) and depth (p = 0.005) showed as constantly increasing from an age <15 to >25 years in the overall assessment. The distribution of the shape of the sella turcica differed significantly between groups (p < 0.001). Conclusions: In this study, CBCT was used to assess the morphology of the sella turcica. A majority of the subjects with cleft had a flattened sella turcica compared to that of the control group. A shorter length of the sella turcica was more evident in the cleft subjects than in the control group.

A Cephalometric Analysis on Magnitudes and Shape of Sella Turcica.

Familiarity with the shape and dimensions of sella turcica is important to recognize and manage pathological conditions of pituitary gland as well as for orthodontic treatment planning. The present study aims to describe the morphology and dimensions of sella turcica from Indian population, using lateral cephalograms to set a reference data for comparison among different races. The study used 36 lateral skull radiographs of both sexes between age group of 13 to 18 years. Shape of sella turcica was noted by visual inspection. Length, height anterior, height median, height posterior, distance between frontonasal suture and mental spine to midpoint of posterior clinoid process, and tuberculum sella were measured using digital vernier caliper with reference to Frankfort line. The results of the study revealed that mean length, height anterior, height median, height posterior were larger in females than in males. The morphological types identified include pointed posterior clinoid process with rounded hypophyseal fossa, hooked posterior clinoid process with rounded hypophyseal fossa, hooked posterior clinoid process with flask-shaped hypophyseal fossa. These observations would be beneficial for the clinicians and orthodontists to design treatment planning in pathology of pituitary gland and in correcting dentofacial anomalies.

Residents' journal review

Residents' journal review

Correlation of Shape and Size of Sella Turcica With the Type of Facial Skeletal Class in an Iranian Group.

Background:In orthodontic science, diagnosis of facial skeletal type (class I, II, and III) is essential to make the correct treatment plan that is usually expensive and complicated. Sometimes results from analysis of lateral cephalometry radiographies are not enough to discriminate facial skeletal types. In this situation, knowledge about the relationship between the shape and size of the sella turcica and the type of facial skeletal class can help to make a more definitive decision for treatment plan.Objectives:The present study was designed to investigate this relationship in patients referred to a dental school in Iran.Patients and Methods:In this descriptive-analytical study, cephalometric radiographies of 90 candidates for orthodontic treatment (44 females and 46 males) with an age range of 14 - 26 years and equal distribution in terms of class I, class II, and class III facial skeletal classification were selected. The shape, length, diameter, and depth of the sella turcica were determined on the radiographs. Linear dimensions were assessed by one-way analysis of variance while the correlation between the dimensions and age was investigated using Pearson’s correlation coefficient.Results:Sella turcica had normal morphology in 24.4% of the patients while irregularity (notching) in the posterior part of the dorsum sella was observed in 15.6%, double contour of sellar floor in 5.6%, sella turcica bridge in 23.3%, oblique anterior wall in 20% and pyramidal shape of the dorsum sella in 11.1% of the subjects. In total, 46.7% of class I patients had a normal shape of sella turcica, 23.3% of class II patients had an oblique anterior wall and a pyramidal shape of the dorsum sella, and 43.3% of class III individuals had sella turcica bridge (the greatest values). Sella turcica length was significantly greater in class III patients compared to class II and class I (P < 0.0001). However, depth and diameter of sella turcica were similar in class I, class II, and class III patients. Furthermore, age was significantly correlated to the diameter of sella turcica as greater diameters were observed in older ages (P < 0.04).Conclusion:A significant relationship exists between the type of facial skeletal classification and the shape of the sella turcica; as in class III patients, sella turcica bridge was reported with a higher frequency. Also, sella turcica had a significantly higher length in these patients than in those with class I and class II facial skeletal types.

Sellar dimension in skeletal class II subjects with different growth patterns

ObjectivesThe purpose of this study was to evaluate and compare size and shape of the sella in skeletal class II subjects with normodivergent, hypodivergent and hyperdivergent growth patterns. Materials/methodsStandardized pre-treatment lateral cephalograms of 90 patients (45 males and 45 females) were selected based on values of five parameters. The sample consisted of 3 groups (normodivergent, hypodivergent and hyperdivergent) having 30 subjects each. The measurements included width, height, length and width/height (W/H) ratio. Student's t-test was used to calculate the differences in sella measurements among males and females of the same group, while one-way analysis of variance was used to determine the relationship between sella measurements and skeletal pattern. W/H ratio was used to assess the shape of the sella turcica. Values of W/H ratio were divided into 3 equal ranges: average, horizontally elongated or flat, and vertically elongated shapes. The shape of the sella turcica in groups was studied with the chi – square test and post-hoc analysis. ResultsThe results showed that the W/H ratio was maximum for hypodivergent and minimum for the hyperdivergent group. (p = 0.000). The average shape of sella turcica was most common among all the groups. No significant difference in mean sella turcica length, width and height was found between the groups. The sella turcica length in males of hypodivergent group was significantly higher as compared to the females of the same group (p = 0.038). Conclusions/implicationsSella turcica shape and dimensions can be used for the future studies as reference when comparing the same with the skeletal growth pattern.

The size and morphology of sella turcica: A lateral cephalometric study

Background: Sella turcica is a saddle-shaped concavity in the body of sphenoid bone situated in the middle cranial fossa of skull, clearly seen on lateral cephalometric radiograph. Aim: The purpose of the study was to measure the size and describe the morphology of sella turcica in different age groups and gender. Materials and Methods: Lateral cephalometric radiographs of 200 subjects of which 100 males and 100 females in the age group of 8-30 years were included in the study population. Linear dimensions which include the length, depth, and anteroposterior diameter were measured and the shape of sella turcica was analyzed and skeletal class of malocclusion was noted. Chi-square test and ANOVA test were used for statistical analysis. Results: In the present study, morphology of sella turcica appeared to be normal shape (upper contour of anterior wall of sella turcica appears to be perpendicular to floor) in 46.5% of the study population and morphological variations in shape were seen in 53.5% of study population. Whereas size was considered there was statistically significant increase in the depth and anteroposterior diameter of sella turcica as age advanced. There was no significant difference in the linear measurements of sella turcica between males and females. Conclusion: The most common shape of sella turcica in the study population was normal shape. There is a gradual increase in the size of sella turcica as age advances.

Size and shape of the sella turcica in subjects withDown syndrome

To study size and shape of the sella turcica in individuals with Down syndrome (DS) and compare them to matched controls without the syndrome. The Department of Pediatric Dentistry and Orthodontics. Lateral cephalograms of sixty DS individuals and sixty controls were obtained with an age range of 12-22 years. The length, depth, and diameter of the sella turcica were calculated. In addition, the shape of the sella turcica was described as either normal or with aberrations such as; oblique anterior wall, sella turcica bridging, extremely low sella turcica, irregularity in the posterior part of the dorsum sella, and pyramidal shape of the dorsum sella. An increase in the diameter and depth of sella turcica was found more frequently in DS group as compared to controls (P < 0.05 and P < 0.0001, respectively). When the shape of the sella turcica was examined, a normal sella turcica shape was found less often in DS (P < 0.05). The most common abnormality detected was an oblique anterior wall (P < 0.05). A sella turcica bridge, irregularity in the posterior wall, and a pyramidal shape of sella turcica were present simultaneously in some individuals with DS (P < 0.01). The sella turcica in DS differs in size and morphology when compared to individuals without the syndrome. The diameter and depth of the sella turcica in DS are larger than controls, with a tendency toward more abnormalities in the shape of sella turcica.

Sella turcica shape, linear dimensions, and cervical vertebrae staging in preorthodontic patients in Benin City, Nigeria

Background: The sella turcica is one of the commonly used orthodontic landmarks in determining and diagnosing various problems of the facial skeleton; with the shape and linear dimensions found to vary in different types of skeletal classes especially during puberty where significant changes of the sella turcica occur. These pubertal changes can be assessed using the stage of maturation of the cervical vertebrae and a method; the Cervical vertebrae Maturation (CVM) method which could aid in the clinical determination of optimal treatment modalities. Materials and Methods: The sella turcica and first six cervical vertebrae were assessed on the cephalometric radiographs of 106 untreated orthodontic patients. Correlations between variables were determined by using the SPSS (version 16) software. Results: A normal sella turcica shape was the most frequently occurring in 65 (61.3%) of the total sample population. Skeletal Class II was the most predominant craniofacial problem in 53 (50%) and in 13 (46.4%) in CVM Stage 3, with a significant difference in the diameter, P < 0.05 in females with a skeletal Class I pattern. Maxillary prognathism with an increased sella-nasion-maxillary point A (SNA) value >90° was highest in 50 (47.2%). There was a significant difference in the diameter of the sella turcica among gender with skeletal Class II. The largest diameter of 18 mm was observed in females and in CVM Stage 4. The mean area of the sella turcica is the same for both CVM Stages 1 and 5 (74.07 mm 2 ). The difference in the area of the sella turcica was highest in the transition between Stages 1 and 2 (8.81 mm 2 ) and similar between Stages 2, 3, and 4 (2.38 mm 2 ). The mean area of the sella turcica demonstrated a sequential increase from CVM Stages 2-6. Conclusion: The CVM stages may be utilized as a diagnostic tool in the clinic to differentiate the pubertal growth spurt and determining the best time for treating certain orthodontic problems. The linear dimensions of the sella turcica cannot be used as a diagnostic tool in determining skeletal classes.

The Size and Morphology of Sella Turcica in Different Skeletal Patterns among South Indian Population: A Lateral Cephalometric Study

Objective: The purpose of the study was to measure the size and describe the morphology of sella turcica in different skeletal types. Materials and methods: Lateral cephalometric radiographs of 180 subjects (91 males, 89 females) in the age group of 9 to 27 years were grouped into skeletal Class I, II, III (60 subjects in each group). Linear dimensions which include the length, depth and anteroposterior diameter were measured and the shape was analyzed. A student t-test was used to calculate the difference in linear dimensions and oneway analysis of variance (ANOVA) was done to study the relationship between sella turcica size and skeletal types. Results: Considering the age groups, linear dimensions were larger in older group than in younger group (p < 0.01). Significant difference was noted in length between males and females (p < 0.05). When skeletal types were compared to the sella size, significant difference was found in the length and diameter. The shape of sella turcica appeared normal in majority of the subjects (61%). Conclusion: Linear dimensions and shape of sella turcica in the current study can be used as reference standards for further investigations involving the sella turcica in South Indian population.

A cephalometric morphometric study of the sella turcica

The purpose of this study was to use quantitative methods to measure the size and shape of the sella turcica and thus establish normative reference standards that could assist in a more objective evaluation and detection of pathological conditions. Standardized lateral cephalograms of 184 healthy Greeks (91 males and 93 females) were used. The age range was between 6 and 17 years. Conventional measurements included three different heights of the sella turcica (anterior, posterior, median), its length, and width, measured in relation to the Frankfort reference line. In addition, the area of sella turcica was calculated. Morphometric methods were used to assess shape. The tracings were superimposed using the Procrustes method, and the average shape was computed. Principal component analysis (PCA) was used to assess shape variability. The data were correlated with centroid size, age, and gender. Unpaired t-tests were used to determine gender differences. Sella height anteriorly was the only variable found to be significantly different between the genders, being larger in females by 0.5 mm. Linear and area measurements were found to be significantly correlated with age, but all correlations were low (r(2) below 8 per cent). Sella turcica shape, as described by PCA, was different between males and females, mainly at the posterior aspect of the sella outline. However, although there was an extensive overlap between the genders, and differences were minimal. Age was not found to be correlated with the shape coefficients, although, in the female group, the first principal component of shape was marginally not significant. Allometry was observed in both genders, the sella showing a tendency towards a flatter and wider shape with increase in size. The results of this study constitute quantitative reference data that could be used for objective evaluation of sella shape.