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Ince R, Cihan ÖF, Bahşi İ, Yalçin ED. Morphometric Analysis of the Sella Turcica on Cone-Beam Computed Tomography Images. J Craniofac Surg 2024:00001665-990000000-01495. [PMID: 38709033 DOI: 10.1097/scs.0000000000010208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 03/09/2024] [Indexed: 05/07/2024] Open
Abstract
INTRODUCTION Sella turcica is an important anatomic formation that contains the pituitary gland and is in a close neighborhood with many vital structures. It is important to know the morphometry of the sella turcica, as it is a transition point during surgical interventions such as the endoscopic endonasal transsphenoidal approach to the region. The findings obtained are thought to be useful in the examination of sella turcica and surrounding structures and will contribute to the literature by knowing the morphometry of the region for the surgical method. METHOD In this study, cone-beam computed tomography images of 400 individuals, 200 females and 200 males, aged between 18 and 65 years, who did not have craniofacial pathology, who applied to Gaziantep University, Faculty of Dentistry between 2015 and 2020 for any reason, were evaluated retrospectively. In the sagittal section, 8 parameters were examined, 6 of which were transverse. RESULTS The length () of the sella turcica in the sagittal plane is 10.19±1.77 mm, the diameter of the sella turcica is 11.6±1.69 mm, the anterior height of the sella turcica is 7.88±1.56 mm, the median height of the sella turcica 8.18±1.42 mm, posterior height of sella turcica 6.98±1.31 mm, width of sella turcica 11.10±1.6 mm. The distance between anterior clinoid processes in the transverse plane was 24.93±2.57 mm, and the distance between posterior clinoid processes was 14.92±2.46 mm. CONCLUSION It was determined that there was an increase in many parameters with age, and length of the sella turcica and anterior clinoid processes were statistically significantly higher in males.
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Affiliation(s)
- Rümeysa Ince
- Vocational School of Health Services, Medical Imaging Techniques Program, Osmaniye Korkut Ata University, Osmaniye
| | - Ömer F Cihan
- Department of Anatomy, Faculty of Medicine, Gaziantep University, Gaziantep
| | - İlhan Bahşi
- Department of Anatomy, Faculty of Medicine, Gaziantep University, Gaziantep
| | - Eda D Yalçin
- Department of Dental and Jaw Radiology Radiology, Faculty of Dentistry, Istanbul Health and Technology University, Istanbul, Turkey
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Chou ST, Lin SH, Chen SC, Chen CM, Tseng YC. Comparison of the transverse cranial base dimension in different craniofacial skeletal relationships: A cone-beam computed tomography study. J Dent Sci 2024; 19:364-376. [PMID: 38303855 PMCID: PMC10829675 DOI: 10.1016/j.jds.2023.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/15/2023] [Indexed: 02/03/2024] Open
Abstract
Background/purpose In comparing the cranial base's size, most cephalometric studies focused on the length and angle in the anteroposterior direction. However, investigating the anterior, middle, and posterior cranial base's transverse dimensions is challenging. This study aimed to investigate the transverse dimensions of the cranial base in different craniofacial skeletal patterns and sexes using cone-beam computed tomography (CBCT). Materials and methods A total of 210 adults (105 males and 105 females), including three different skeletal relationships, were included in the study. The cranial base dimensions were measured on a three-dimensional image structure rendered by CBCT. Statistical methods included the Kappa statistic for analysis of consistency and reproducibility and the independent t-test for differences in cranial base dimensions between sexes. A general linear model (GLM) was used to compare the transverse size of the cranial base among skeletal Class I, II, and III groups. The Pearson correlation coefficient explored the correlation among the cranial base dimensions. Results The cranial base dimensions did not differ significantly between skeletal Class I, II, and III. The more prominent cranial base size was found in males than females, except for the crista galli length (CGL) and cribriform ethmoid plate width (CEPW). The cranial base dimensions did not differ significantly between different skeletal relationships. Most dimensions have significant correlations in the middle and the posterior cranial base. Conclusion The cranial base's transverse dimensions in Taiwanese adults show no significant differences between craniofacial skeletal relationships. In the middle and posterior cranial base, transverse measurements reveal significant sexual dimorphism.
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Affiliation(s)
- Szu-Ting Chou
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Orthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Shih-Hsuan Lin
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Orthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Shih-Chieh Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Orthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chun-Ming Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Oral and Maxillofacial Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yu-Chuan Tseng
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Orthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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Papaefthymiou P, Ozbilen EO. Sella turcica morphometrics in subjects with down syndrome. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101559. [PMID: 37442343 DOI: 10.1016/j.jormas.2023.101559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/10/2023] [Accepted: 07/10/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVE Since the number of patients diagnosed with Down syndrome seeking orthodontic treatment is increasing, clinicians could contribute by applying diagnostic modalities used frequently in the orthodontic field for research purposes. Thus, The aim of the present study is to implement morphometric methods to investigate the size and shape of sella turcica in subjects with Down syndrome. MATERIALS AND METHODS In this retrospective study, archive records of 24 individuals with Down syndrome were compared to 48 healthy controls matched for age and gender. Parameters such as sella anterior, midpoint, and posterior height were measured, as well as sella width, area, and length were calculated. Independent sample t-tests were applied for the comparison of differences in sella turcica dimensions. Geometric morphometric analysis of the sella was performed with, implementing methods such as Procrustes superimposition and principal component analysis. Statistical significance was set at p<0.05. RESULTS Statistically significant differences were found for sella anterior height, sella midpoint height, sella posterior height, sella maximum height, sella length, and sella area. All the aforementioned values were significantly increased in the Down syndrome subjects (p<0.05). Principal component analysis (PCA) depicted a statistically significant difference in sella shape between patients with Down syndrome and healthy controls (p<0.05). CONCLUSIONS Subjects with Down syndrome presented significantly increased sella turcica dimensions as well statistically significant differences in shape compared to healthy controls.
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Affiliation(s)
- Petros Papaefthymiou
- School of Dentistry, Department of Orthodontics, Marmara University, Istanbul, Turkey.
| | - Elvan Onem Ozbilen
- School of Dentistry, Department of Orthodontics, Marmara University, Istanbul, Turkey
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Iskra T, Stachera B, Możdżeń K, Murawska A, Ostrowski P, Bonczar M, Gregorczyk-Maga I, Walocha J, Koziej M, Wysiadecki G, Balawender K, Żytkowski A. Morphology of the Sella Turcica: A Meta-Analysis Based on the Results of 18,364 Patients. Brain Sci 2023; 13:1208. [PMID: 37626564 PMCID: PMC10452851 DOI: 10.3390/brainsci13081208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/04/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND This meta-analysis aimed to present data on the sella turcica (ST) morphology and variations. Furthermore, a detailed morphometric analysis of the ST was conducted. METHODS Major online databases such as PubMed, Scopus, Embase, Web of Science, and the Cochrane Library were searched through. The overall search process was conducted in three stages. RESULTS This meta-analysis was based on the results of 18,364 patients and demonstrates the most up-to-date and relevant data regarding the morphology of the ST in the available literature. Four classification methods of the ST shape can be distinguished, in which the most commonly occurring variants are the normal ST (55.56%), the U-shaped ST (73.58%), the circular type of ST (42.29%), and non-bridging ST (55.64%). The overall midpoint height of the ST was 6.59 mm (SE = 0.13). The overall length of the ST was 9.06 mm (SE = 0.15). The overall volume of the ST was 845.80 mm3 (SE = 288.92). Four main classification methods of ST morphology can be distinguished in the available literature. Various morphometric characteristics of the ST may be applied in clinical practice to evaluate its shape, dimensions, and normal or pathological variants.
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Affiliation(s)
- Tomasz Iskra
- Department of Anatomy, Jagiellonian University Medical College Cracow, 33-332 Kraków, Poland; (T.I.); (B.S.); (K.M.); (A.M.); (P.O.); (M.B.); (J.W.); (M.K.)
| | - Bartłomiej Stachera
- Department of Anatomy, Jagiellonian University Medical College Cracow, 33-332 Kraków, Poland; (T.I.); (B.S.); (K.M.); (A.M.); (P.O.); (M.B.); (J.W.); (M.K.)
- Youthoria—Youth Research Organization, 33-332 Kraków, Poland
| | - Kamil Możdżeń
- Department of Anatomy, Jagiellonian University Medical College Cracow, 33-332 Kraków, Poland; (T.I.); (B.S.); (K.M.); (A.M.); (P.O.); (M.B.); (J.W.); (M.K.)
| | - Agnieszka Murawska
- Department of Anatomy, Jagiellonian University Medical College Cracow, 33-332 Kraków, Poland; (T.I.); (B.S.); (K.M.); (A.M.); (P.O.); (M.B.); (J.W.); (M.K.)
| | - Patryk Ostrowski
- Department of Anatomy, Jagiellonian University Medical College Cracow, 33-332 Kraków, Poland; (T.I.); (B.S.); (K.M.); (A.M.); (P.O.); (M.B.); (J.W.); (M.K.)
- Youthoria—Youth Research Organization, 33-332 Kraków, Poland
| | - Michał Bonczar
- Department of Anatomy, Jagiellonian University Medical College Cracow, 33-332 Kraków, Poland; (T.I.); (B.S.); (K.M.); (A.M.); (P.O.); (M.B.); (J.W.); (M.K.)
- Youthoria—Youth Research Organization, 33-332 Kraków, Poland
| | - Iwona Gregorczyk-Maga
- Faculty of Medicine, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland;
| | - Jerzy Walocha
- Department of Anatomy, Jagiellonian University Medical College Cracow, 33-332 Kraków, Poland; (T.I.); (B.S.); (K.M.); (A.M.); (P.O.); (M.B.); (J.W.); (M.K.)
- Youthoria—Youth Research Organization, 33-332 Kraków, Poland
| | - Mateusz Koziej
- Department of Anatomy, Jagiellonian University Medical College Cracow, 33-332 Kraków, Poland; (T.I.); (B.S.); (K.M.); (A.M.); (P.O.); (M.B.); (J.W.); (M.K.)
- Youthoria—Youth Research Organization, 33-332 Kraków, Poland
| | - Grzegorz Wysiadecki
- Department of Normal and Clinical Anatomy, Chair of Anatomy and Histology, Medical University of Lodz, 90-752 Łódź, Poland
| | - Krzysztof Balawender
- Department of Normal and Clinical Anatomy, Institute of Medical Sciences, Medical College, Rzeszow University, 35-315 Rzeszów, Poland;
| | - Andrzej Żytkowski
- Norbert Barlicki Memorial Teaching Hospital No. 1, Medical University of Lodz, 90-001 Łódź, Poland;
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Feng Q, Liu S, Peng JX, Yan T, Zhu H, Zheng ZJ, Feng HC. Deep learning-based automatic sella turcica segmentation and morphology measurement in X-ray images. BMC Med Imaging 2023; 23:41. [PMID: 36964517 PMCID: PMC10039601 DOI: 10.1186/s12880-023-00998-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 03/14/2023] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND Although the morphological changes of sella turcica have been drawing increasing attention, the acquirement of linear parameters of sella turcica relies on manual measurement. Manual measurement is laborious, time-consuming, and may introduce subjective bias. This paper aims to develop and evaluate a deep learning-based model for automatic segmentation and measurement of sella turcica in cephalometric radiographs. METHODS 1129 images were used to develop a deep learning-based segmentation network for automatic sella turcica segmentation. Besides, 50 images were used to test the generalization ability of the model. The performance of the segmented network was evaluated by the dice coefficient. Images in the test datasets were segmented by the trained segmentation network, and the segmentation results were saved in binary images. Then the extremum points and corner points were detected by calling the function in the OpenCV library to obtain the coordinates of the four landmarks of the sella turcica. Finally, the length, diameter, and depth of the sella turcica can be obtained by calculating the distance between the two points and the distance from the point to the straight line. Meanwhile, images were measured manually using Digimizer. Intraclass correlation coefficients (ICCs) and Bland-Altman plots were used to analyze the consistency between automatic and manual measurements to evaluate the reliability of the proposed methodology. RESULTS The dice coefficient of the segmentation network is 92.84%. For the measurement of sella turcica, there is excellent agreement between the automatic measurement and the manual measurement. In Test1, the ICCs of length, diameter and depth are 0.954, 0.953, and 0.912, respectively. In Test2, ICCs of length, diameter and depth are 0.906, 0.921, and 0.915, respectively. In addition, Bland-Altman plots showed the excellent reliability of the automated measurement method, with the majority measurements differences falling within ± 1.96 SDs intervals around the mean difference and no bias was apparent. CONCLUSIONS Our experimental results indicated that the proposed methodology could complete the automatic segmentation of the sella turcica efficiently, and reliably predict the length, diameter, and depth of the sella turcica. Moreover, the proposed method has generalization ability according to its excellent performance on Test2.
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Affiliation(s)
- Qi Feng
- College of Medicine, Guizhou University, Guiyang, 550025, China
| | - Shu Liu
- Department of Orthodontics, Guiyang Hospital of Stomatology, Guiyang, 550002, China
| | - Ju-Xiang Peng
- Department of Orthodontics, Guiyang Hospital of Stomatology, Guiyang, 550002, China
| | - Ting Yan
- Department of Radiology, Guiyang Hospital of Stomatology, Guiyang, 550002, China
| | - Hong Zhu
- Department of Medical Information, Guiyang Hospital of Stomatology, Guiyang, 550002, China
| | - Zhi-Jun Zheng
- Department of Orthodontics, Guiyang Hospital of Stomatology, Guiyang, 550002, China
| | - Hong-Chao Feng
- College of Medicine, Guizhou University, Guiyang, 550025, China.
- Department of Oral and Maxillofacial Surgery, Guiyang Hospital of Stomatology, Guiyang, 550002, China.
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Chou ST, Chen CM, Chen PH, Lin YC, Tseng YC. The left and right differences in sella turcica bridging between sex analyzed by cone-beam computed tomography. J Dent Sci 2023; 18:220-228. [PMID: 36643255 PMCID: PMC9831791 DOI: 10.1016/j.jds.2022.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/04/2022] [Indexed: 01/18/2023] Open
Affiliation(s)
- Szu-Ting Chou
- School of Dentistry and Graduate Program of Dental Science, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,Department of Orthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chun-Ming Chen
- School of Dentistry and Graduate Program of Dental Science, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,Department of Oral and Maxillofacial Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ping-Ho Chen
- School of Dentistry and Graduate Program of Dental Science, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ying-Chun Lin
- Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan,Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Chuan Tseng
- School of Dentistry and Graduate Program of Dental Science, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,Department of Orthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan,Corresponding author. School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, San-Ming District, Kaohsiung 80708, Taiwan.
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Canigur Bavbek N, Akay G, Kar İ, Tuncer C, Güngör K, Baloş Tuncer B. Relationship between palatally impacted canines and dimensions and morphology of sella turcica: A cone-beam computed tomography study. Am J Orthod Dentofacial Orthop 2022; 162:626-635. [PMID: 35953339 DOI: 10.1016/j.ajodo.2021.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 05/01/2021] [Accepted: 05/01/2021] [Indexed: 11/01/2022]
Abstract
INTRODUCTION This study aimed to analyze the association of unilateral and bilateral palatal canine impaction with the dimensions and morphology of sella turcica from 3-dimensional cone-beam computed tomography (CBCT) images. METHODS CBCT images of patients with bilateral (BPI) (n = 12; 9 female 3 male; 20.75 ± 5.88 years) and unilateral (UPI) (n = 35; 22 female 13 male; 19.28 ± 5.57 years) palatally impacted canines were compared with a control group (n = 56; 34 female 22 male; 20.82 ± 4.88 years). Linear measurements regarding sella turcica were made, and its morphologic variations were categorized. Two group comparisons were made with the Student t test or Mann-Whitney U-test, whereas one-way analysis of variance or Kruskal-Wallis tests were used for multiple group comparisons. Categorical variables were compared using the chi-square or Fisher exact test as appropriate. The binary logistic regression analyses and correlations using Spearman or Pearson correlation analyses were used to determine associations between variables (P <0.05). RESULTS Sella diameter was significantly smaller in the BPI group compared to UPI and control groups. There was a significant association between sella diameter and BPI when compared with the control group (χ2[1] = 9.150; P = 0.008). There were no significant differences between groups in the distribution of sella turcica morphology. CONCLUSIONS Despite the similar genetic origin of the sella turcica region and teeth, the association of palatal canine impaction with dimensions and morphology of sella turcica was weak. Both local and genetic factors might contribute to the ectopic position of the canine.
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Affiliation(s)
- Nehir Canigur Bavbek
- Department of Orthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey.
| | - Gülsün Akay
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - İrem Kar
- Department of Biostatistics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Cumhur Tuncer
- Department of Orthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Kahraman Güngör
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Burcu Baloş Tuncer
- Department of Orthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
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Nerurkar S, Kamble R, Shrivastav S, Sanchla A, Kaiser J, Mathew J, Toshniwal N. The Comparative Evaluation of the Morphology and Dimensions of the Sella Turcica in Skeletal Class III Patients and Patients With Unilateral Cleft Lip and Palate in Post-Pubertal Age Group. Cureus 2022; 14:e29730. [PMID: 36340533 PMCID: PMC9621744 DOI: 10.7759/cureus.29730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 09/29/2022] [Indexed: 11/18/2022] Open
Abstract
Background The clinical features of unilateral cleft patients have great similarity to class III patients, viz., ANB <2° and Wits appraisal <-3 mm. In this study, we determined the frequency of various shapes of the sella in cleft and class III patients. We also measured the dimensions of the sella turcica in the aforementioned groups. Studying the morphology and dimensions of the sella in different groups can help us to understand the role of the cranial base in the development of malocclusion. Material and methods The study is composed of 46 patients, divided into two groups with an age range of 14 to 21 years. The linear dimensions of the sella were measured, and the shape of the sella was determined. Comparison was done between the two groups using Student’s t-test. Result When the two groups were compared, length was found to be similar in both groups, but depth and diameter were greater in the class III group. An abnormal shape of the sella was found predominantly in both class III and cleft cases. The normal morphology accounted for only 13.04% of all the cleft patients, whereas 39.13% of the class III cases exhibited a normal shape of the sella. Sella turcica bridging was seen in 30.43% of cleft patients as opposed to 21.73% of class III patients exhibiting the bridging. Conclusion With the finding that 74% of the subjects exhibited abnormal morphology of the sella, confirming that it can be one of the factors for malocclusion must be given more consideration.
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Life Quality of Children Affected by Cleft Lip Palate and Alveolus (CLPA). CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9050757. [PMID: 35626934 PMCID: PMC9139314 DOI: 10.3390/children9050757] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 11/17/2022]
Abstract
The aim of this study was to investigate the quality of life of children and adolescents affected by cleft lip, palate and alveolus (CLPA) in the Italian population after a tailored treatment dental program. A prospective study was conducted with subjects of both genders at the University Hospital of Pisa, Italy. This study included 32 patients (11 females and 21 males, mean age: 9.8 ± 2.1 years old) affected by CLPA (test group); a tailored oral hygiene instruction protocol was adopted in the test group since early age (6.1 ± 0.9 years old) after corrective surgery and regular dental hygiene appointments were scheduled. Moreover, a control group of 32 patients (11 females and 21 males, mean age: 10.1 ± 2.2 years old) without CLPA was included; control subjects were first-visit patients, matched for age and sex, who had not received a specific dental hygiene program before. The OHIP-14 (Oral Health Impact Profile) questionnaire was applied for the evaluation of the quality of life of patients of both groups and the questions were presented directly to the patients. Moreover, the DMFT (Decayed, Missed and Filled Teeth) index was measured. A statistical analysis was performed and the level of significance was set at: p < 0.05. The OHIP-14 scores presented significant differences between the two groups (p < 0.05); the test group exhibited a lower mean OHIP-14 score in comparison to the control group. The DMFT score was significantly lower in the test group in comparison to controls (p: 0.001, p < 0.05). The quality of life and DMFT score of children and adolescents affected by CLPA, after a tailored treatment dental program, were better than that of the subjects of the control group.
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Rennert RC, Brandel MG, Steinberg JA, Nation J, Couldwell WT, Fukushima T, Day JD, Khalessi AA, Levy ML. Maturation of the sella turcica and parasellar region: Surgical relevance for anterior skull base approaches in pediatric patients. Clin Neurol Neurosurg 2022; 215:107168. [PMID: 35247690 DOI: 10.1016/j.clineuro.2022.107168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/13/2022] [Accepted: 02/02/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Traditional and extended transnasal transsphenoidal approaches provide direct access to a variety of anterior skull base pathologies. Despite increased utilization of transnasal approaches in children, anatomic studies on pediatric skull base maturation are limited. We herein perform a surgically relevant morphometric analysis of the sella and parasellar regions during pediatric maturation. METHODS Measurements of sellar length (SL), sellar depth (SDp), sellar diameter (SDm), interclinoid distance (ID), intercavernous distance (ICD), and the presence of sphenoid sinus pneumatization (SSP), and sphenoid sinus type (SST) were made on thin-cut CT scans from 60 patients (evenly grouped by ages 0-3, 4-7, 8-11 12-15, 16-18, and >18 years) for analysis. Data were analyzed by sex and age groups using t-tests and linear regression. RESULTS Sella and parasellar parameters did not differ by sex. SL steadily increased from 8.5 ± 1.2 mm to 11.5 ± 1.6 mm throughout development. SDp and SDm increased from 6.0 ± 0.9 mm to 9.3 ± 1.4 mm and 9.0 ± 1.6 mm to 14.4 ± 1.8 mm during maturation, with significant interval growth from ages 16-18 to adult (p < 0.01). ID displayed significant growth from ages 0-3 to 4-7 (18.0 ± 2.4 mm to 20.7 ± 1.9 mm; p = 0.002) and ICD from ages 0-3 to 8-11 (12.0 ± 1.8 mm to 13.5 ± 2.1 mm; p < 0.001), without further significant interval growth. SSP was not seen in patients < 3, but was 100% by ages 8-11. SSTs progressed from conchal/presellar (60% at ages 4-7) to sellar/postsellar (80% at adulthood). CONCLUSION The sella and parasellar regions have varied growth patterns with development. Knowledge of the expected maturation of key anterior skull base structures may augment surgical planning in younger patients.
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Affiliation(s)
- Robert C Rennert
- Department of Neurological Surgery, University of California, San Diego, La Jolla, CA, United States
| | - Michael G Brandel
- Department of Neurological Surgery, University of California, San Diego, La Jolla, CA, United States
| | - Jeffrey A Steinberg
- Department of Neurological Surgery, University of California, San Diego, La Jolla, CA, United States
| | - Javan Nation
- Department of Head and Neck Surgery, University California San Diego, San Diego, CA, United States
| | - William T Couldwell
- Department of Neurosurgery, University of Utah, Salt Lake City, UT, United States
| | | | - John D Day
- Department of Neurosurgery, University of Arkansas, Little Rock, AR, United States
| | - Alexander A Khalessi
- Department of Neurological Surgery, University of California, San Diego, La Jolla, CA, United States
| | - Michael L Levy
- Department of Neurosciences and Pediatrics, University of California San Diego, San Diego, CA, United States.
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Morphology of Sella Turcica and Bridging Prevalence Correlated with Sex and Craniofacial Skeletal Pattern in Eastern Asia Population: CBCT Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6646406. [PMID: 33860047 PMCID: PMC8009724 DOI: 10.1155/2021/6646406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 02/28/2021] [Accepted: 03/15/2021] [Indexed: 12/03/2022]
Abstract
Purpose Sella turcica bridging (STB) refers to a rare anatomical variation formed by the ossification of the ligament between the anterior and posterior clinoid processes. The presence of the STB was significantly correlated with craniofacial skeleton classification and a higher prevalence rate in skeletal Class III. The current study is aimed at investigating the dimensions of sella turcica and the prevalence of STB in different sexes and on the three craniofacial skeletal patterns using cone beam computed tomography (CBCT). Materials and Methods A total of 159 adults (66 males and 93 females), including 3 different craniofacial skeletal patterns (skeletal Classes I, II, and III), were included in the study. The sella turcica dimensions and the prevalence of STB were calculated. An independent t-test and generalized linear model were used to compare the differences in the sella turcica dimensions and the skeletal relations. The Spearman rank correlation coefficient was used to analyze the correlations between sella turcica dimensions and skeletal relation. Results The sella length (SL) was 11.05 ± 1.80 mm for males and 10.77 ± 1.56 mm for females. The anterior clinoid distance (ACD) which was measured for the anterior width of sella turcica showed 25.83 ± 2.04 mm and 24.04 ± 2.28 mm for males and females, respectively (p < 0.0001). The overall percentage of complete bridging and partial bridging was 6.6% and 56.9%, respectively. Complete bridges were more common in males (males: 9.1%, females: 4.8%), and partial bridges were more frequent in females (males: 49.2%, females: 62.4%). Both sexes differed with respect to sella turcica dimensions. Moreover, males had a significantly larger ACD, posterior clinoid distance (PCD), and diameter of sella turcica (DST), on both sides, relative to females. Conclusion The prevalence rate of complete STB in the Taiwanese population was 6.6%. Significant differences between sexes were found in sella turcica dimensions. The prevalence rates of STB as well as the sella turcica dimensions did not significantly differ between different craniofacial skeletal patterns (skeletal Classes I, II, and III).
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