Evaluation of the cranial base and sella turcica morphology in patients with unilateral cleft lip and palate

Abstract

OBJECTIVE:The aim of this study was to investigate the size and morphology of the sella turcica and cranial base in individuals with unilateral cleft lip and palate (UCLP), and to compare it with individuals showing Class III discrepancy due to maxillary deficiency (CL3) and with individuals having normal (CL1) craniofacial development.MATERIALS AND METHOD: This retrospective study was carried out on the lateral cephalogram tracings of UCLP (10 females, 4 males; 12.05±1.14 years), CL3 (10 females, 5 males; 11.73±0.89 years) and CL1 (10 females, 5 males; 13.11±1.11 years) patients. Linear and angular measurements related to sella turcica and cranial base were performed. Intergroup comparisons were either made with one-way ANOVA followed by Tukey's test or with Kruskal-Wallis test with Bonferroni adjustment (p<0.05). Spearman correlation coefficient was used for correlations (p<0.01). RESULTS: The length of the maxilla (Co-A) was shorterin UCLP (p=0.035) and CL3 (p=0.001) than in CL1. Total cranial length (Ba-N) was greater in UCLP than in CL3 (p=0.012) and CL1 (p=0.016). Cranial base angle (N-S-Ar°) was less in CL3 than in UCLP (p=0.001) and CL1 (p=0.009). Ba-N (p=0.003) and anterior cranial length (S-N) (p=0.000) were positively correlated with Co-A. Posterior cranial length (S-Ba) was positively correlated with ramus height (Ar-Go) (p=0.001). The diameter of sella was bigger in CL1 than in CL3 (p=0.025). The prevalence of morphologic variations of sella turcica in UCLP was higher (71.4%) than in control groups. CONCLUSION:Although there was a Class III tendency in UCLP due to maxillary deficiency, cranial base flexure characteristic to CL3 anomalies was not seen in this group. The existence of UCLP or CL3 did not alter dimensions of sella turcica, but morphologic variations were more common in UCLP.

Caudal Septal Deviation

“…The ANS and PNS are both stable osseous landmarks of the maxillary crest and the base of the nasal septum and are, therefore, more likely to avoid cranial asymmetry. Structures such as the sella turcica and basion are variable morphologic landmarks that should be used with caution 18–20 …”

“…Structures such as the sella turcica and basion are variable morphologic landmarks that should be used with caution. [18][19][20] Despite providing valuable insights, this study has several limitations. The main purposes of this case series were to create an objective, CT-based evaluation method and to investigate its feasibility; therefore, we used already available data.…”