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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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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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Paknahad M, Shahidi S, Abbasi R, Paknahad M. Evaluation of the Prevalence of Atherosclerosis Within the Course of Internal Carotid Artery in Cone Beam Computed Tomography Images. Indian J Otolaryngol Head Neck Surg 2022; 74:5242-5251. [PMID: 36742500 PMCID: PMC9895759 DOI: 10.1007/s12070-020-01958-y] [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: 05/22/2020] [Accepted: 07/07/2020] [Indexed: 02/07/2023] Open
Abstract
The aim of the present study was to retrospectively evaluate the gender-related and age-related prevalence and severity of calcifications within the segments of the internal carotid artery in cone beam computed tomography (CBCT). By using a documented visual scale, out of 400 CBCT examinations a total of 304 CBCT scans of adult patients over 40 years old were evaluated as to the prevalence and severity of intracranial calcifications within the segments of the internal carotid artery. Calcifications were found in 117 CBCT scans. These calcifications were detected along the extracranial (C1: 53%), petrous (C2: 22.2%), Lacerum (C3:27%), cavernous (C4: 94%), and ophthalmic-clinoid (C5/C6: 65%) segments. The Friedman test showed significant differences in the severity of calcifications among the internal carotid artery segments. The McNemar test showed no significant differences between calcifications on the right or left side segments. The Chi square test showed no significant differences in the prevalence of calcifications between men and women; it also showed that the prevalence of calcifications increased with increase in age (P < 0.05). In this study, the frequency and severity of calcifications decreased throughout the C4, C5/C6, and C1 segments in a descending order; moreover, an increased incidence of calcifications by increase in age was documented irrespective of gender.
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Affiliation(s)
- Maryam Paknahad
- Oral and Dental Disease Research Center, Oral and Maxillofacial Radiology Department, Dental School, Shiraz University of Medical Sciences, Zand Street, Shiraz, 7144833586 Iran
| | - Shoaleh Shahidi
- Biomaterials Research Center, Oral and Maxillofacial Radiology Department, Dental School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Roshanak Abbasi
- Student Research Committee, Dental School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Majid Paknahad
- Radiology Department, Medical School, Fasa University of Medical Sciences, Fasa, Iran
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Antonarakis GS, Huanca Ghislanzoni L, Fisher DM. Sella turcica dimensions and maxillary growth in patients with unilateral cleft lip and palate. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e916-e921. [PMID: 35697253 DOI: 10.1016/j.jormas.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 06/08/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVES We aimed to investigate associations between sella turcica dimensions and maxillary growth in children with unilateral cleft lip and palate (UCLP). METHODS Forty-nine patients with non-syndromic UCLP, prior to secondary alveolar bone-grafting, were included. The outcomes measured were sella turcica and maxillary cephalometric measurements, and scores representing dental arch relationships derived from dental casts. On lateral cephalograms, sella width, height, and area were measured, as well as maxillary length, height, protrusion, and inclination. Dental arch relationships were measured using the modified Huddart/Bodenham (MHB) scoring system, and translated GOSLON yardstick score. Multiple linear regression was used to assess associations between sella turcica measurements and either cephalometric parameters or MHB/GOSLON scores, including age and sex as covariables. RESULTS No significant associations were found between sella turcica dimensions and dental arch relationships. For cephalometric measurements, sella height and area were associated with basal maxillary length, alveolar maxillary length, and anterior maxillary height. CONCLUSIONS Sella height and area seem to be predictors for both maxillary length and height as assessed cephalometrically, in a sample of patients with non-syndromic UCLP.
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Affiliation(s)
- Gregory S Antonarakis
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Switzerland.
| | - Luis Huanca Ghislanzoni
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Switzerland
| | - David M Fisher
- Division of Plastic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
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Izadparast Y, Shahidi S, Paknahad M, Moradi A. Feasibility of CBCT in Diagnosing Otosclerosis by Measuring CBCT Bone Density: A Preliminary Study. Indian J Otolaryngol Head Neck Surg 2022; 74:322-328. [PMID: 36213485 PMCID: PMC9535058 DOI: 10.1007/s12070-021-02502-2] [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: 12/27/2020] [Accepted: 03/02/2021] [Indexed: 10/21/2022] Open
Abstract
The aim of this study was to measure cone beam computed tomography (CBCT) derived bone density of 6 anatomic points around the otic capsule in preoperative assessment of patients with clinically suspected otosclerosis, and to compare these densities with control group. CBCT images of 21 patients (34 ears, the otosclerosis group) with surgically confirmed otosclerosis and 26 patients (52 normal ears, the control group) were evaluated in this prospective study. Six regions of interest (ROI) were set manually around the otic capsule with the slice thickness of 0.3 mm. The mean CBCT bone density these regions were measured and compared in the case and control groups. In the case group, the mean CBCT bone density at the fissula ante fenestram (FAF) was significantly lower than the control group. Moreover, at the 4 points of the other ROIs (3-6) CBCT bone densities were significantly lower in the case group compared to the control group (p < 0.01). In this group, among 13 bilateral otosclerosis, 22 ears had conductive hearing loss (CHL), 4 ears had mixed hearing loss (MHL) and among 8 unilateral otosclerosis, 5 ears had CHL, 3 ears had MHL. Our study showed the mean CBCT bone density of ROIs 1 and 6 were correlated with the average air-bone gap in the bilateral and unilateral otosclerosis group, respectively. Quantitative evaluation of CBCT with a slice thickness of 0.3 mm can be used as a suitable tool for diagnosis and follow-up of otosclerosis in temporal bone.
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Affiliation(s)
- Yalda Izadparast
- Otolaryngology Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Shoaleh Shahidi
- Biomaterials Research Center, Oral and Maxillofacial Radiology Department, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Paknahad
- Oral and Dental Disease Research Center, Oral and Maxillofacial Radiology Department, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Anis Moradi
- Oral and Maxillofacial Radiology Department, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Akay G, Eren I, Karadag O, Gungor K. Three-dimensional assessment of the sella turcica: comparison between cleft lip and palate patients and skeletal malocclusion classes. Surg Radiol Anat 2020; 42:977-983. [PMID: 32356044 DOI: 10.1007/s00276-020-02481-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/23/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE The main aim of the present study was to investigate the dimensions and morphological appearance of the sella turcica in cleft lip and palate patients using cone-beam computed tomography (CBCT) images, compared to non-cleft individuals. METHODS CBCT images of 40 (20 females and 20 males) cleft lip and palate patients and 60 (27 males and 33 females) non-cleft individuals were assessed, retrospectively. The linear dimensions (depth, diameter and length) of the sella turcica and inter-clinoid distance were measured. Sella turcica shapes were examined in the cleft lip and palate patients and non-cleft individuals. Non-cleft individuals were divided into skeletal malocclusion classes. All variables were analyzed using the Kruskal-Wallis test, Mann-Whitney U tests and Chi-square test. RESULTS No significant difference was observed between individuals with and without cleft in the linear dimensions (depth, diameter and length) of the sella turcica (p > 0.05). However, a significant difference was found in the inter-clinoid distance between patients with cleft and non-cleft individuals (p < 0.05). Comparison of the sella turcica shape between skeletal malocclusion classes and patients with cleft showed significant differences (p < 0.05). CONCLUSIONS No significant difference was determined in the depth, diameter, or length of the sella turcica in cleft patients when compared with non-cleft individuals. The inter-clinoid distance was lower in cleft patients than in non-cleft individuals, and this difference was statistically significant.
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Affiliation(s)
- Gulsun Akay
- Department of Oral and Dentomaxillofacial Radiology, Faculty of Dentistry, Gazi University, Ankara, Turkey.
| | - Ilkay Eren
- Ministry of Health, Osmanlı Oral and Dental Health Center, Ankara, Turkey
| | - Ozge Karadag
- Department of Statistics, Graduate School of Science and Engineering, Hacettepe University, Ankara, Turkey
| | - Kahraman Gungor
- Department of Oral and Dentomaxillofacial Radiology, Faculty of Dentistry, Gazi University, Ankara, Turkey
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Antonarakis GS, Huanca Ghislanzoni L, La Scala GC, Fisher DM. Sella turcica morphometrics in children with unilateral cleft lip and palate. Orthod Craniofac Res 2020; 23:398-403. [PMID: 32304274 DOI: 10.1111/ocr.12380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 03/24/2020] [Accepted: 04/12/2020] [Indexed: 11/27/2022]
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.
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Affiliation(s)
- Gregory S Antonarakis
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Luis Huanca Ghislanzoni
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Giorgio C La Scala
- Division of Pediatric Surgery, Department of Pediatrics, University Center of Pediatric Surgery of Western Switzerland, Geneva University Hospitals, Geneva, Switzerland
| | - David M Fisher
- Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
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Ugurlu M, Bayrakdar IS, Kahraman F, Oksayan R, Dagsuyu IM. Evaluation of the relationship between impacted canines and three-dimensional sella morphology. Surg Radiol Anat 2019; 42:23-29. [PMID: 31501910 DOI: 10.1007/s00276-019-02328-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 08/31/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of this study was to assess the three-dimensional morphometric features of the sella turcica using cone beam computed tomography (CBCT) in subjects with unilateral and bilateral maxillary impacted canines and normal controls. METHODS In this retrospective study, CBCT images captured with ultra-low dose protocol of 73 subjects (21 males, 52 females; mean age 20.01 ± 6.53 years) with unilateral or bilateral maxillary impacted canines (29 unilateral and 29 bilateral) and 15 controls were evaluated. Nineteen different measurements of the pituitary fossa were made on CBCT images. To evaluate the normality, the Kolmogorov-Smirnov test was used. The nonparametric statistical Kruskal-Wallis and Mann-Whitney U tests were applied to analyze the significant differences among and between the groups. Statistical significance was set at 5%. RESULTS No measurement differed significantly among the groups (all p > 0.05) other than the right sella length, which differed between the unilateral and bilateral test groups and the unilateral test group and controls (both p < 0.05). The bilateral test group and control group did not differ significantly, but both exhibited greater right sella length than did the unilateral test group (p > 0.05). CONCLUSIONS Other than the right sella length, there were no among-group differences in the mean pituitary fossa measurements of subjects with impacted unilateral and bilateral canines and normally erupted canines. The right sella length was lower in subjects with impacted unilateral canines than in those with bilateral impacted canines and normal controls.
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Affiliation(s)
- Mehmet Ugurlu
- Department of Orthodontics, Faculty of Dentistry, Eskisehir Osmangazi University, Eskisehir, 26240, Turkey
| | - Ibrahim Sevki Bayrakdar
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Eskisehir Osmangazi University, Eskisehir, 26240, Turkey.
| | - Fatih Kahraman
- Department of Orthodontics, Faculty of Dentistry, Eskisehir Osmangazi University, Eskisehir, 26240, Turkey
| | - Rıdvan Oksayan
- Department of Orthodontics, Faculty of Dentistry, Eskisehir Osmangazi University, Eskisehir, 26240, Turkey
| | - Ilhan Metin Dagsuyu
- Department of Orthodontics, Faculty of Dentistry, Eskisehir Osmangazi University, Eskisehir, 26240, Turkey
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Morphometric Analysis of Sella Turcica Using Cone-Beam Computed Tomography in Patients With Cleft Lip and Palate. J Craniofac Surg 2019; 31:306-309. [PMID: 31449220 DOI: 10.1097/scs.0000000000005881] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE The purpose of this study is to evaluate morphometric analysis of sella turcica using cone-beam computed tomography (CBCT) in patients with cleft lip and palate (CLP) and healthy controls. METHODS Cone-beam computed tomography images of 68 patients (36 males, 32 females, age range 7-20 years) with CLP and 68 healthy individuals (36 males, 32 females, age range 8-19 years) were examined retrospectively. Sella turcica shapes were analyzed by 2 different methods in CLP and control groups. Length, depth, and diameter of sella turcica were measured in both groups. The data were statistically assessed by age, gender using Independent t-test and one-way analysis. RESULTS Diameter of sella turcica was smaller in CLP group compared to healthy individuals (P < .05). Length and depth of sella turcica were lower than in control group, but not statistically significant (P > .05). Sella turcica shape significantly differed between groups (P < .05). The most common sella turcica types were flattened and irregular shapes in CLP group, whereas round and normal shapes were in control group. There was no significant difference between groups in any dimension of sella turcica by gender (P > .05). Sella turcica depth was significantly higher at age of 15 years and above in CLP group. CONCLUSION This study showed that flattened and irregular shapes of sella turcica were the most common types in CLP group. Smaller sella turcica was detected in CLP group compared to healthy individuals. Cone-beam computed tomography can be useful for evaluation of sella turcica.
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