Sella turcica morphometrics in children with unilateral cleft lip and palate

Abstract

Objective: To use morphometric methods to investigate the size and shape of the sella turcica in children with unilateral cleft lip and palate (UCLP). Setting and sample population: Fifty-six healthy children with non-syndromic UCLP, from a major paediatric teaching hospital, with lateral cephalograms taken prior to alveolar bone grafting, were compared with an age-and sex-matched control group of healthy children without orofacial clefts, with lateral cephalograms taken prior to orthodontic treatment. Materials and methods: In this cross-sectional study, conventional measurements were performed on the sella turcica to measure width, height and area on lateral cephalograms. Sella shape was also analysed using 11 points defining the sella turcica contours, using geometric morphometrics. Procrustes superimposition was used to register all sella contour tracings to calculate average sella shape. Principal component analysis was applied to the residuals of the point coordinates, and principal components (PCs) of shape were extracted. Results: Statistically significant differences between the UCLP and control groups were found for sella posterior height, midpoint height, maximum height and area, where all of these were smaller in children with UCLP. Principal component analysis revealed that the first two PCs accounted for 84.7% of total shape variance. There was a statistically significant difference in sella shape between children with UCLP and control children. Conclusions: In children with UCLP, the sella turcica is shorter and with a smaller surface area when compared to matched non-cleft children. Moreover, sella turcica shape, when disregarding size, seems to differ to that of non-cleft children. K E Y W O R D S geometric morphometrics, sella turcica, unilateral cleft lip and palate 1 | INTRODUC TI ON The size and shape of the sella turcica has attracted some attention in the orthodontic literature, as it is readily visible on lateral cephalometric radiographs taken routinely for orthodontic diagnosis. Large variation has been seen both in the size and the shape of the sella turcica, 1-5 making the establishment of norms complicated.

Sella turcica morphometrics in subjects with down syndrome

“…When sella turcica was examined in subjects with other pathological conditions either syndromic (e.g., Williams syndrome) or with multifactorial etiology (e.g., cleft lip and palate) significant dimensional differences were evident Antonarakis et al, 2020). On 55 the contrary to the present study, sella turcica in the aformentioned conditions presented decreased sized in comparison with healthy controls Antonarakis et al, 2020).…”

“…Finally, it is interesting that the results related to the principal components (PCs) present differences from the studies on sella shape of Antonarakis et al and Andreadaki et al on unilateral cleft lip and palate subjects and non-cleft and non-syndromic individuals respectively (Andredaki et al, 2007;Antonarakis et al, 2020). In the first study conducted by Antonarakis et al the variance of PC1, PC2 and PC3 were 57,8 %, 26,9%, and 8,6% respectively, whereas Andreadaki et al presented similar values (Andredaki et al, 2007;Antonarakis et al, 2020). Interestingly in the present study the first three PC presented more evenly distributed variance.…”

“…Nevertheless, to our knowledge only three studies examined the sella turcica structure in individuals with Down syndrome presenting partially similar but also controversial results (Russell and Kjaer, 1999;4 Korayem and AlKofide, 2015;Hasan et al, 2019). Recently, some authors attempted to examine the size and shape of sella turcica in healthy and non-syndromic cleft lip and palate subjects by implementing geometric morphometric techniques (Andredaki et al, 2007;Antonarakis et al, 2020). This methodology possesses the advantage of eliminating the differences that arise from the orientation of the lateral cephalometric radiographs and of the sella turcica itself, in order not to affect the measurements of sella dimensions, as well as the analysis of shape.…”

The first 3D analysis of the sphenoid morphogenesis during the human embryonic period

“…Thus, it can be inferred that the sphenoid is a controversial and significant structure regarding not only the morphogenesis of the cranial base but also the features of a human-specific cranium and face. Furthermore, it has been reported that malformations of the sphenoidal region can be observed in many congenital craniofacial deformities, including craniosynostosis, cleft lip and palate 12 , 13 , Down syndrome 14 – 16 , and others 17 , 18 , which emphasize the importance of the sphenoid in the pathogenesis of these anomalies. Recent advances in imaging techniques have led to the realization of the significance of the sphenoid, including evolutionary and developmental aspects, and many anatomists have been keenly interested in the unique shape of the sphenoid as it has been called by various names since ancient Greece 19 ; however, the detailed process of the morphogenesis of the sphenoid itself remains unknown.…”

Evaluation of Dimension and Bridging of Sella Turcica and Presence of Ponticulus Posticus in Individuals With and Without Cleft: A Comparative Study

“…13 According to the previous studies, the sella turcica is smaller in all dimensions in patients with unilateral lip/palate cleft compared to the individuals without cleft. 14 Moreover, the prevalence of STB and PP in patients with cleft is relatively high. 10,15 The previous studies have measured the presence of PP and STB among western and Asian populations 16–16 but through the review of literature, we have found that the prevalence of these measures and their association with cleft lip/palate have not yet been studied in the Iranian population.…”