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

Abstract

The sphenoid bone which is located in the middle of the skull base articulates with most of the bones forming the skull. The so-called corpus sphenoidale is the body of sphenoid bone. The concavity in the middle part of the upper surface of corpus sphenoidale is the hypophyseal fossa, in which the hypophysis lies. [1,2] The hypophyseal fossa is limited by the tuberculum sellae anteriorly and dorsum sellae posteriorly. The two small processes on both sides of the tuberculum sellae are named as middle clinoid processes and the small processes on the superior lateral corners of the dorsum sellae are the posterior clinoid processes. The hypophyseal fossa is examined in three parts, namely, the anterior wall, poste-Abstract 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.

Radiological Measurement of Sella Turcica Dimensions in Different Skeletal Patterns in Romanian Patients

“…Sathyanarayana discovered a statistically significant difference in length and diameter between the sexes, whereas Axelsson discovered a statistically significant difference in length between males and females in their study [25]. Alkofide, Shrestha, Oktem, Nagaraj, and Shah found no significant difference between males and females [20,26,29,30,32]. According to Silverman's study, the dimensions of the sella turcica are generally equivalent across sexes after the pubertal development spurt, which occurs around 2-3 years later in males than in females [21].…”

“…Extensive studies on the size of the sella turcica have been published using various measuring methods. The mean length values that have been reported are 8.13 mm in the Shrestha G.K. study, 8.4 mm in the Motwani study, 9.1 mm in the Sathyanarayana HP study, 9.74 mm in the Öktem study, 10.3 mm in the Alkofide study, 11.3 mm in the Shah AM study, and 12 mm in the Ouaknine and Hardy study [20,[26][27][28][29][30][31]. In the current study, the length varied from 6.12 mm (the lowest) to 12.45 mm (the highest), with a mean of 8.98 mm.…”

Sella turcica morphology in patients with genetic syndromes: A systematic review

“…The pituitary gland lies within the pituitary fossa which is situated in the body of the sphenoid bone, within the cranium (Figure 1). 10,12 The pituitary gland is very important for endocrine function and its development is closely related to that of the sella turcica 13,14 . Thus, anomalies in the pituitary gland often present as abnormalities in the sella turcica 2,15 .…”

“…10,12 The pituitary gland is very important for endocrine function and its development is closely related to that of the sella turcica. 13,14 Thus, anomalies in the pituitary gland often present as abnormalities in the sella turcica. 2,15 Pathological conditions associated with enlargement include adenomas, Rathke's cleft cysts and aneurysms.…”

Sella Turcica Morphology in Patients With Genetic Syndromes: Protocol for a Systematic Review

“…The pituitary gland is located within the pituitary fossa, which is situated in the body of the sphenoid bone, within the cranium [ 10 , 12 ]. The pituitary gland is particularly important for endocrine function, and the development of the sella turcica is closely associated with that of the pituitary gland [ 13 , 14 ]. Thus, anomalies in the pituitary gland often present as abnormalities in the sella turcica [ 2 , 15 ].…”