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IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)
e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 16, Issue 6 Ver. III (June. 2017), PP 126-132
www.iosrjournals.org
DOI: 10.9790/0853-160603126132 www.iosrjournals.org 126 | Page
A Study To Evaluate The Shape And Size of Sella Turcica And Its
Correlation with The Type of Malocclusion on Lateral
Cephalometric Radiographs
1Mukta B. Motwani,2 Rohit Biranjan,3Apeksha Dhole,
4Anuraag B. Choudhary,5Apurva Mohite
1Professor & Head, Department Of Oral Medicine & Radiology, VSPM’s Dental College & Research Centre,
Nagpur, India
2Post Graduate Student, Department Of Oral Medicine & Radiology, VSPM’s Dental College &
Research Centre, Nagpur, India.
3Professor, Department Of Oral Medicine & Radiology, VSPM’s Dental College &
Research Centre, Nagpur, India
4Associate Professor, Department Of Oral Medicine & Radiology, VSPM’s Dental College &
Research Centre, Nagpur, India
5Senior Lecturer, Department Of Oral Medicine & Radiology, VSPM’s Dental College & Research Centre,
Nagpur, India
Abstract
Introduction: Lateral cephalograms display numerous cranial, facial and oral anatomic structures along with sella
turcica which is considered vital for many radiographic analyses. It is demarcated by dense thin white line and is
used to measure the position of maxilla & mandible in relation to the cranial base and to themselves. Various studies
have found an association between morphological variations of sella to malocclusion and also gender differences
have been noted. This retrospective study was carried out to evaluate these morphological variations of sella turcica
and its relation to type of malocclusion.
A
Ai
im
m:
:
To determine dimensions and morphological variations of sella turcica in different age groups & correlation
between sella and type of malocclusion.
M
Ma
at
te
er
ri
ia
al
ls
s
A
An
nd
d
M
Me
et
th
ho
od
ds
s: 200 lateral cephalometric images of the patients more than age group of 8 years and less
than 25 years were selected. The morphological variations, linear measurements of sella turcica and the skeletal type
classification, based on ANB angle was determined. Length, depth, antero-posterior diameter (linear dimentions)
were measured and correlated with the type of malocclusion.
Results: Out of the total sample studied, it was found that, when linear measurements were assessed, there was
statistically significant difference found between the length and antero-posterior diameter of sella turcica. When
skeletal type malocclusion was assessed, there was no significant correlation found between sella morphology, linear
dimensions and the different types of malocclusion.
Conclusion: The study showed significant correlation between the length and the anteroposterior diameter with the
advancing age which signifies that growth of the individual can be assessed based on the size of sella turcica at
different age periods.
Keywords: Lateral cephalogram, Sella turcica, Sella dimensions and morphology, Type of malocclusion.
I. Introduction
A lateral cephalometric radiograph displays numerous cranial, facial and oral anatomic structures
imaged from lateral aspect and which aids in diagnosis, treatment planning and predicting the treatment outcome. It is
used to assess the craniofacial morphology, allowing to distinguish between dentoalveolar malocclusions and skeletal
discrepancies. Apart from facial structures, fossa cranii media, including the sella turcica, are visible on these
radiographs.[1,2] Proper analysis of the craniofacial skeleton on lateral cephalogram depends upon accurate
identification and location of defined anatomical and constructed landmarks. Sella turcica is considered important
landmark for many of radiographic analysis of the neurocranial and craniofacial complex. Sella turcica is a saddle-
shaped concavity in the body of the sphenoid bone situated in the middle cranial fossa of the skull which is variable in
size and shape. [ 2] It can be deep or shallow in both children and adults. [2] Sella turcica gets its name from Turkish
language because of its similarity to the Turkish saddle. The depression in saddle is noted as pituitary fossa or
hypophyseal fossa, [3] as the pituitary gland is situated here. In lateral cephalometric radiographs, the sella turcica is
usually demarcated by a dense thin white line and such a landmark is used to measure the positions of maxilla and the
position of mandible in relation to the cranium base and to themselves.[5] Sella turcica on lateral cephalometric
radiograph can be observed clearly and consecutively traced during cephalometric analysis.[4]
A Study To Evaluate The Shape And Size Of Sella Turcica And Its Correlation With…
DOI: 10.9790/0853-160603126132 www.iosrjournals.org 127 | Page
According to the study conducted by Kucica et al, it was found that children with abnormal structure of
sella, especially with sella turcica bridges are characterized by significantly higher incisor inclination angles and a
more distal position of the alveolar part of the mandible.[1] This indirectly indicates a more distal position of the
maxillary and mandibular basal bones than in unaffected individuals and also confirms general aetiology of
malocclusion. Malocclusion, a distortion of the normal growth and development‘ can be skeletal or dental in origin.
Various angular and linear measurements have been incorporated in various cephalometric analyses for
characterization of patient‘s craniofacial skeleton and also to help clinicians in diagnosing the amount of skeletal and
dental discrepancies, contributing towards the presenting malocclusions. [6,] Since there is an increasing interest in the
study of human craniofacial dysmorphology, it is essential to estabilish the cephalometric norms for the normal
growth and development of sella turcica and should be carried out during cephalometric analysis.
Thus, the aim of this study was to determine the average dimensions and morphological variations of the
sella turcica in different age groups and its correlation with the type of malocclusion on lateral cephalometric
radiographs in the study population visiting VSPM dental college and research centre, Nagpur (Maharashtra). The
objective of the study was, to evaluate correlation between linear dimensions and morphology of the sella turcica with
gender and to evaluate correlation between linear dimensions and morphology of the sella turcica in subjects with
different skeletal pattern.
II. Method
After obtaining permission from the ethical committee, 200 lateral cephalograms in the age group of 8-25
years, which had good quality, in which all cephalometric structutres were clearly visible, which showed good
reproduction of the sella turcica were retrieved from the existing 2 years record of the patients in the Department of
Oral Medicine and Radiology, V.S.P.M Dental college, Nagpur. These cephalograms were grouped into four
categories based on age i.e <10 years, 10-15 years, 16-20 years, 21-25 years. All cephalograms were analysed as
monitor-displayed images using Kodak dental software program. Radiographs with congenital defects in the
craniofacial region like clefts and other malformations and the radiographs of subjects with less than 8 years of age
and more than 25 years were not selected.
1) Distribution into skeletal classes
Classification of skeletal type type into Class I, Class II, or Class III was be based on the ANB angle (SNA and SNB)
from Stiener Analysis. The ANB angle indicates the magnitude of the skeletal jaw discrepancy, regardless of which
jaw is affected.
Skeletal base Class were categorised as follows:
1.1 Angle from 0-4 degrees - Class 1
1.2 Angle more than 4 degrees - Class II, and
1.3 Angle less than 0 degrees Class III.
2) Size of sella turcica
Three linear measurements of the sella turcica i.e. length, antero-posterior diameter and depth in mid-sagittal plane
were obtained in accordance to Silverman and Kisling methods.8,9
2.1. The length of sella turcica was measured as the linear distance from the superior most point on the
tuberculum sella to the tip of the dorsum sella.
2.2 The depth was measured as a line perpendicular from the line joining tuberculum sella and dorsum sella to
the inferior most point on the floor.
2.3 The anteroposterior diameter of sella turcica was measured from the superior most point on tuberculum sella
to the furthest point on the posteroinferior aspect of the hypophyseal fossa.(fig 1)
3) Shape And Morphological Appearance Of Sella Turcica
Shape and morphological appearance of sella turcica was assessed according to the method described by
Axelsson et al.[8] According to Axelsson et al., the five morphological variations are oblique anterior wall, bridging of
sella turcica, double contour of the floor, irregular surface (notch like depression) in the posterior aspect of the
dorsum sella, and pyramid shape of dorsal sellae. [8]
III. Results And Statistical Analysis
Data were analysed using the Statistical software SPSS version 18. P-value was estimated using one way
analysis of variance for distribution of subjects and comparison of measurement of sella turcica according to age
intervals. Pair wise comparison of mean length of sella turcica and mean A-P diameter of sella turcica according to
age age intervals was also observed. A Student‘s t -test was used to calculate the mean differences in sella turcica
linear dimensions between males and females (significance level<0.05). Distribution of subjects on the basis age and
as per types of morphology was observed. Distribution of subjects on the basis gender, types of malocclusion and
A Study To Evaluate The Shape And Size Of Sella Turcica And Its Correlation With…
DOI: 10.9790/0853-160603126132 www.iosrjournals.org 128 | Page
types of morphology was seen. To study the relationship between skeletal type and sella turcica size, t-test for
independent samples was performed. Distribution of subjects on the basis of gender as per groups of morphology was
also analysed. Distribution of subjects on the basis of types of malocclusion as per groups of morphology was even
observed.
1) Size of sella turcica
The linear measurements of sella turcica in various age groups are presented in table 1. Length of sella
turcica consistently went on increasing as the age advances, which was not true with the height/depth and the
diameter (decreased in the last age group) Table 1. When level of significance was carried out, it was observed that P
value was significant with only the length and not with the other two linear dimension (depth/height and the
diameter). The average length, depth and diameter of the sella turcica is shown for male and female in table 2. The
mean length of sella turcica in males and females varied by only 0.978 mm being 9.104 mm in males and 8.126 mm
in females, suggesting men have wider sella as compared to females Table 2. Similarly when comparison of the mean
diameter between both genders was carried out, it was found that, the mean value varied by only 0.179 mm being
10.185 mm in females and 10.006 mm in males. On comparison of mean depth between the male and female the
values also varied by 0.29 mm i.e. in females the depth/height was more as compared to males. Finally, on comparing
the p value in all three linear dimension between genders, it was found that only the length parameter showed
significant difference and no difference was observed in depth and diameter of sella turcica. (table 2)
2) Morphology/ Shape of sella turcica
Normal sella morphology was predominant in all the age groups whereas the next common was the sella
bridge.(table 3). On seeing the morphology of sella turcica in each the skeletal types, the results showed that In
skeletal class I patients 48.10% (38/79) of patient had normal sella and 46.15% (18/39) of the patients had sella bridge
(Table 4). In skeletal class II patients 51.89% (41/79) of the patients had a normal sella and 53.84% (21/39) of the
patients has sella bridge. Sella bridge was more common in class II patients (table 4). The present study did not find
images of class III or skeletal class III patients to analyse the data, as the images were retreived randomly and hence
the data was confined to class I and class II subjects‘ images only.
3) Skeletal pattern and linear dimensions of sella turcica
In order to determine if the patients with different skeletal pattern presented with different linear dimensions
irrespective of age and gender, a student t-test was performed. No significant difference was found between the
different linear dimensions and skeletal pattern. The mean difference between skeletal pattern with different linear
dimension are shown in table 5.
IV. Discussion
It is known that at the age of 8 years, the mean diameter of the sella turcica is 10mm and at the age of 16
years, it is 11 mm. It is strictly dependent on hypophysal morphology, thus, size alterations may be symptoms of
glandular pathology and should be subjected to further diagnosis.2 Morphological aberrations of the sella turcica
described in the literature are bridge, oblique anterior wall, double contour of the floor, irregularity (notching) in the
posterior part of the dorsum sella and pyramidal shape of the dorsum sellae.8,9,14,15,16,17 However, it should be
remembered that the two-dimensional representation of an abnormality system does not really provide complete
information about its three-dimensional structure. An infinitive number of three-dimensional sizes and shapes can
yield an identical two-dimensional radiographic image, which constitutes a well proven mathematical fact inherent to
two-dimensional radiography.
1) Shape/Morphology of Sella turcica
In the previous years Gorden and Bell (1922) classified sella into shapes (circular, oval or flat/saucer shaped
but they concluded that not all the cases could easily be put into such a broad three way classification.[15] Then in
1950 David and Epstein used the term J shaped sella while omega shaped sella was given by Pournier and Denizet in
1965.[18] However in 1969 Kier termed these definitions radiographical myths, advising that both should be
disregarded since they were used to characterize abnormal pathology as well as normal developmental patterns.[18]
In a recent study by Axelsson et al in 2004, shape of the sella turcica was divided into six main types; normal
sella turcica, oblique anterior wall, double – contoured sella, sella turcica bridge, irregularity (notching) in the
posterior part of the sella and pyramidal shape of the dorsum sellae.[8] Alkofide in 2007 did a similar study using the
same 6 main types of sella shapes as Axelsson et al has used, and, he reported the similar findings, that, the normal
variation of sella shape was almost in 67 % (2/3rd) of the subjects.[9,8] In our study the normal variation was observed
in 39.5% of the subjects whereas 60.5 % had different variations. These values are not in accordance to study by
Axelsson and Alkofide.[8,9]
A Study To Evaluate The Shape And Size Of Sella Turcica And Its Correlation With…
DOI: 10.9790/0853-160603126132 www.iosrjournals.org 129 | Page
The finding of an irregular notching of the dorsum sella was very less in the current study being 3% whereas
in Axelsson study it was 11% and Sathyanarayana et al it was 15%.[8,13] Similarly the pyramidal shape of the dorsum
sella was more frequent in the current study than the former.[3,8,13] The difference in the values between the two
studies can be attributed to the ethnic difference between the two samples.
The double contour frequency was also found in less number in the present study (only 1.5%) than the
former study. [3,8,13] The oblique anterior wall has been documented in normal (Axelsson), as well as in children
suffering from lumbosacral myeomeningocele and seckel syndrome.[19] The current study showed only 5.5 % of
subjects with an oblique anterior wall which is not in agreement to Axelsson et al(26%) and Nagraj et al(29%) but in
accordance to Kucia A et al, Shah AM et al(4%),Alkofide (9.4%) and Satyanarayan et al(5%). The another
description regarding sella turcica was ― sella bridge ‖ which was given recently by Camp JD.16 The frequency of
sella turcica bridge in the present study has been presented in table 4. In previous studies on healthy subjects, the
occurrence of sella bridging ranged from 4.6% to 11.1%.[5,8] In present study sella turcica bridge was found to be
19.5% which is in accordance to Axelson et al who also found that the presence of sella turcica bridge in normal
individual is not uncommon and is seen in 5.5%-22% of the subjects[8]. Present study is not in accordance with the
study by Shah et al and Alkofide.[1,9] It raisies an interesting point for future studies as to whether the bridging
variation of sella type even exists in normal individuals or not.
The higher occurrence of sella turcica bridge in females in the present study supports earlier findings by
Axelsson et al.[8] Apart from bridging, the present study also supports a higher prevalence of sella turcica bridges in
patients with malocclusion than in healthy individuals, and the same was also previously reported by Jones et al and
Meyer-Marcotty et al.[10,5] Moreover, a higher prevalence of sella turcica bridging and abnormal sella turcica
dimensions has been found in subjects who had combined surgical–orthodontic treatment than in subjects who were
treated by orthodontic means only.[10] Similarly, a higher frequency of sella turcica bridge has been found in patients
with severe craniofacial deviations too.[11] Marsan G and Oztas E¸ Meyer-Marcotty et al and Sathyanarayana et al
reported that sella turcica bridges are more frequent in Class III patients.[12,5,13] These findings were not in accordance
to the present study as the current study found more sella bridges in class II cases.
These finding have a clinical significance, since the presence of a skeletal component of a malocclusion makes
the treatment always more complex than a malocclusion of dentoalveolar origin only.
2) Size of sella turcica
Similar to the morphological studies numerous studies have been done on the size of sella turcica, however
the methods differ widely. Camp reported value of the width (termed as length in our study) being 10.6 mm , Shah
AM et al found 11.3 mm, Quakinine and Hardy found 12 mm, Asad and Hamid found 14.9 and Alkofide who
observed length to be 10.3mm.[16,1,20,21,9] In present study the length ranged from a (minimum)5.918mm-
11.614mm(maximum) with a mean of 8.4mm. There is slight amount of differences between the values founds in
present study and various other studies but these differences are due to different methods of measurements used and
the ethnicity. Average height(vertical diameter) found by Quakinine and Hardy was 8mm, in Camp‘s study, they
found it to be 8.1mm, Nagraj T et al showed the value as 8mm, Asad and Hamid found it as 6.4mm, Alkofide
observed the height to be 10.3mm and Shah‘s finding was 9.9mm.[20,16,3,21,9,20] Height in the present study varied from
(minimum)4.393mm-8.25(maximum) with a mean of 6.06mm, which is less than the values found in the previous
studies except for the study by Quakinine and Hardy, where the value of height was similar.[20] Quakinine and Hardy
added that when measuring the size of sella turcica the height of the gland was usually 2mm shorter than the depth of
sella turcica.(i.e. the gland does not fill the whole volume of the sella turcica) [20]
Antero-posterior diameter with the values ranging from 7.532mm-12.626mm, mean of 9.94mm also varied in
this study. Quakinine and Hardy found antero-posterior diameter to be 8mm, Nagraj et al found it to be 12mm
Alkofide found it to be 14mm and Shah also found it to be 14mm.[20,3,9,1] In determining if gender played a difference
in terms of sella size, present study found a significance difference between males and females in terms of length.
This was not in agreement with the study reported by Israel, Axelssons et al, Nagraj et al, Alkofide who concluded
that the sella turcica size in young adults males and females were almost the same.[22,8,3,9] The finding that the increase
in size of the sella turcica with age in males was similar to the study carried out by Israel, Silverman, Shah AM,
Nagraj et al, Axelsson et al and Sathyanarayan et al and Alkofide.[22,23,1,3,8,13,9] The reason for this is the pubertal
growth spurt which occurs 2 years earlier, as reported by Hass. Hass also reported in 1954 that when compared the
mean size of sella turcica in terms of sella turcica area in millimetres square till the age of 17, the area of sella turcica
in males was more however after age of 17 years, the sella turcica area in females is slightly larger compared to
males. When age criteria was concerned present study was in accordance to the study by Axelsson et al, Nagraj et al
but only in terms of diameter which went on increasing with the age.[8,3] The current study was not in accordance to
their[8,3] study in terms of depth/height of sella. In terms of length and diameter, the current study and the study by
Alkofide was in accordance to eachother.[9]
3) Relation of Sella turcica with Malocclusion
A Study To Evaluate The Shape And Size Of Sella Turcica And Its Correlation With…
DOI: 10.9790/0853-160603126132 www.iosrjournals.org 130 | Page
The literature shows that there have been very few studies comparing the skeletal type of malocclusion with
the sella turcica size to evaluate whether there exists any relation between the two. Present study did not find any
significant correlation between the size of sella and the type of malocclusion. This is in agreement with the study
conducted by Preston, Shah AM et al and Sthyanarayan et al but not in accordance to Alkofide who found correlation
in Class III with the one of the three linear measurement, the diameter. [25,1,13,9]
Thus, by seeing the above discussion of this literature, each orthodontist and general dental practioner should
be familiar with the different shapes and sizes of sella turcica, to help in differentiation and distinguishing pathology
from the normal development patterns.
V . Figures and Tables
Figures
Fig 1
TS - Tuberculum sella
DS - Dorsum sella
BPF - Base of the pituitary fossa
TABLES:
Table 1: Distributionof Subjects and Comparisonof Measurement of Sella Turcica according to age intervals (N=200)
Age (in years)
No. (%)
Length (Mean ± SD)
Height (Mean ± SD)
A-P Diameter (Mean ± SD)
≤ 10
28 (14)
7.514 ± 1.596
5.521 ± 1.128
8.996 ± 1.464
11-15
85 (42.5)
8.258 ± 2.255
6.241 ± 1.487
10.246 ± 1.574
16-20
65 (32.5)
8.871 ± 2.761
6.474 ± 1.614
10.465 ± 2.161
21-25
22 (11)
9.177 ± 2.437
6.041 ± 1.771
10.091 ± 1.587
200 (100)
0.0104*
0.2120*
0.0034*
*P-value estimated usingone way analysis of variance;P-value in bold indicate statistical significance
Table 2: Distribution of subjects and comparisonof measurement of Sella turcica as per gender (n=200)
Gender
No. (%)
Length (Mean ± SD)
Height (Mean ± SD)
A-P Diameter (Mean ± SD)
Male
67 (33.5)
9.104 ± 2.583
6.001 ± 1.533
10.006 ± 2.092
Female
133 (66.5)
8.126 ± 2.263
6.291 ± 1.538
10.185 ± 1.679
200 (100)
0.0096*
0.2102*
0.5440*
*P-value estimated using t-test for independent samples;P-value in bold indicate statistical
significance
Black line- length of the sella
Dashed line - antero-posterior diameter of sella
Dotted line- depth of sella
A Study To Evaluate The Shape And Size Of Sella Turcica And Its Correlation With…
DOI: 10.9790/0853-160603126132 www.iosrjournals.org 131 | Page
Table 3: Distribution of subjects on the basis age and as per types of morphology (n=200)
Morphology
Age (in years) [No. (%)]
≤ 10
11-15
16-20
21-25
Normal sellaturcica
11 (39.29)
32 (37.65)
29 (44.62)
7 (31.82)
Bridge
0
18 (21.18)
16 (24.62)
5 (22.73)
Hypertrophic posterior clinoid process
1 (3.57)
4 (4.71)
2 (3.08)
1 (4.55)
Hypotrophic posterior clinoid process.
0
3 (3.53)
1 (1.54)
1 (4.55)
Irregularity (notching) in the posterior part of the
sellaturcica.
0
2 (2.35)
1 (1.54)
3 (13.64)
Pyramidal shape of the dorsum sellae
8 (28.57)
10 (11.76)
5 (7.69)
0
Double contour of the floor.
0
0
2 (3.08)
1 (4.55)
Oblique anterior wall
2 (7.14)
7 (8.24)
1 (1.54)
1(4.55)
Oblique contour of the floor
6 (21.43)
9 (10.59)
8 (12.31)
3 (13.6)
Total
28 (100)
85 (100)
65 (100)
22 (100)
Table 4: Distribution of subjects on the basis gender, types of malocclusion and types of morphology (n=200)
Morphology
No. (%)
Gender [No. (%)]
Type of malocclusion [No. (%)]
Male
Female
I
II
Normal sellaturcica
79 (39.5)
28 (41.79)
51 (38.35)
38 (38.38)
41 (40.59)
Bridge.
39 (19.5)
10 (14.93)
29 (21.80)
18 (18.18)
21 (20.79)
Hypertrophic posterior clinoid
process
8 (4)
3 (4.48)
5 (3.76)
5 (5.05)
3 (2.97)
Hypotrophic posterior clinoid
process.
5 (2.5)
4 (5.97)
1 (0.75)
1 (1.01)
4 (3.96)
Irregularity (notching) in the
posterior part of the sellaturcica.
6 (3)
2 (2.99)
4 (3.01)
5 (5.05)
1 (0.99)
Pyramidal shape of the dorsum sellae
23 (11.5)
11 (16.42)
12 (9.02)
13 (13.13)
10 (9.90)
Double contour of the floor.
3 (1.5)
1 (1.49)
2 (1.50)
1 (1.01)
2 (1.98)
Oblique anterior wall
11 (5.5)
3 (4.48)
8 (6.02)
6 (6.06)
5 (4.95)
Oblique contour of the floor
26 (13)
5 (7.46)
21 (15.79)
12 (12.12)
14 (13.86)
Total
200 (100)
67 (100)
133 (100)
99 (100)
101 (100)
Table 5: Distribution of subjects and comparisonof measurements of Sella turcica according to type of malocclusion
(n=200)
Type of malocclusion
No. (%)
Length (Mean ± SD)
Height (Mean ± SD)
A-P Diameter (Mean ± SD)
I
99 (49.5)
8.573 ± 2.368
6.323 ± 1.608
10.217 ± 1.792
II
101 (50.5)
8.338 ± 2.464
6.067 ± 1.464
10.035 ± 1.859
200 (100)
0.4920*
0.2410*
0.4805*
*P-value estimated using t-test for independent samples
Table 6: Distribution of subjects on the basis of gender as per groups of morphology
Gender
Groups of morphology [No. (%)]
Normal
Variant
Male
28 (35.44)
39 (32.23)
Female
51 (64.56)
82 (67.77)
Total
79 (100)
121 (100)
Table 7: Distribution of subjects on the basis of types of malocclusion as per groups of morphology
Malocclusion
Morphology categories [No. (%)]
Normal
Variant
I
38 (48.10)
61 (50.41)
II
41 (51.90)
60 (49.59)
Total
79 (100)
121 (100)
VI. Conclusion
The finding that children with malocclusion have sellar abnormalities (either in the form of sizes or shapes) confirms
a systemic aetiology of occlusal discrepancies. Assessment of the sella turcica should be carried out by orthodontist
and general dental practioners during cephalometric analysis. The linear measurements (length, depth and height of
sella)) can be used to measure thesize of pituitary gland and it might be of clinical importance when abnormal size of
A Study To Evaluate The Shape And Size Of Sella Turcica And Its Correlation With…
DOI: 10.9790/0853-160603126132 www.iosrjournals.org 132 | Page
sella is found on lateral cehalograms. Growth of the individual can be assessed based on the size of the sella turcica
at different age periods. VII . Clinical significance
The linear dimensions of sella turcica can be used to approximate the pituitary gland size. A larger size may be an
indication of pituitary tumor leading to Cushing‘s syndrome, amenorrhea, acromegaly. The enlarged sella turcica on a
radiograph has been found to be associated with adenomas, mucocele, meningioma, primary hypothyroidism,
prolactinoma, gigantism, acromegaly, empty sella syndrome, and Nelson syndrome. A small size may lead to
decreased pituitary function causing symptoms such as short stature and retarded skeletal growth. Small sella turcica
are notable in humans who either have an absent or a partial formed diaphragma sellae. In contrast, an abnormally
small sella turcica seems to be rare and found in primary hypopituitarism and Sheehan‘s syndrome. Growth of the
individual can be assessed based on the size of the sella turcica at different age periods.
Limitations
1. The present study was lacking in the data regarding class III subjects.
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