Morphometric Analysis of the Sella Turcica and Sphenoid Sinus: A Retrospective Cross-Sectional Study / Análisis Morfométrico de la Silla Turca y Seno Esfenoidal: Un Estudio Transversal Retrospectivo

SUMMARY: This study evaluated the effects of ethnicity, sex, and age on the linear dimensions of the sella turcica (ST) and the pneumatization patterns of the sphenoid sinus (SS). In this cross-sectional retrospective study, we examined digitally standardized computed tomography scans of 100 Jordanians. These study participants comprised 50 men and 50 women, and their age ranged from 23 years to 77 years. We assessed linear ST dimensions and SS pneumatization patterns and correlated this data to age and sex. Furthermore, we compared the data with different ethnic groups from previous studies. The mean (standard deviation [SD]) length, diameter, width, and depth of the ST were 9.98 (1.89) mm, 12.45 (2) mm, 11.96 (1.76) mm, and 8.38 (1.63) mm, respectively. The mean (SD) interclinoid diameter was 8.84 (2.03) mm. These measurements were not significantly correlated with sex or age. With regards to pneumatization patterns of the sphenoid sinus, the conchal type was observed in 2 % of the study participants. Presellar involvement was observed in 30 % of the patients. The sellar and postsellar type was observed in 66 % and 2 % of patients, respectively. In our study, ST measurements did not differ significantly between the sexes. Pneumatization patterns of the SS differed from the patterns reported for other races. The findings of this study could assist neurosurgeons, orthodontists, and forensic medical investigators in diagnosing and planning treatment for pituitary gland pathologies.

Este estudio evaluó los efectos de la etnia, el sexo y la edad sobre las dimensiones lineales de la silla turca y los patrones de neumatización del seno esfenoidal (SE). En este estudio retrospectivo transversal, examinamos tomografías computarizadas estandarizadas digitalmente de 100 jordanos. Los participantes del estudio comprendían 50 hombres y 50 mujeres entre los 23 y los 77 años de edad. Evaluamos las dimensiones lineales del SE y los patrones de neumatización del SE y correlacionamos estos datos con la edad y el sexo. Además, comparamos los datos con diferentes grupos étnicos de estudios previos. La media (desviación estándar) de la longitud, el diámetro, el ancho y la profundidad del SE fueron 9,98 (1,89) mm, 12,45 (2) mm, 11,96 (1,76) mm y 8,38 (1,63) mm, respectivamente. El diámetro interclinoideo medio era de 8,84 (2,03) mm. Estas medidas no se correlacionaron significativamente con el sexo o la edad. Con respecto a los patrones de neumatización del seno esfenoidal, el tipo conchal se observó en el 2 % de los participantes del estudio. Se observó afectación preselar en el 30 % de los pacientes. El tipo selar y postsillar se observó en el 66 % y el 2 % de los pacientes, respectivamente. En nuestro estudio, las medidas del SE no difirieron significativamente entre los sexos. Los patrones de neumatización de la silla turca diferían de los patrones informados para otras razas. Los hallazgos de este estudio podrían ayudar a los neurocirujanos, ortodoncistas e investigadores médicos forenses en el diagnóstico y el tratamiento de las patologías de la hipófisis.

Investigation of the relationship between "sella turcica bridge" and "ponticulus posticus": a lateral cephalometric study / Investigación sobre la relación entre "puente silla turca" y "ponticulus posticus": un estudio cefalométrico lateral

The ponticulus posticus (PP) is a bridge of bone sometimes found on the atlas vertebra surrounding the vertebral artery and the first cervical nerve root. Sella turcica bridging (STB) is the fusion of anterior and posterior clinoid processes. The objective of this study was to find out the association between STB and PP. For the study, 752 digital lateral cephalograms were retrieved from the archived records of Necmettin Erbakan University, Faculty of Dentistry, Konya, Turkey. There was a significant relationship between the presence of STB and PP (p=0.000, p<0.001). This study indicates that there is a significant correlation between the presence of STB and PP.

El Ponticulus Posticus (PP) es un puente de hueso que se encuentra, a veces, en el atlas y rodea la arteria vertebral y la primera raíz del nervio cervical. El puente de la silla turca (PST) es la fusión de los procesos clinoides anteriores y posteriores. El objetivo de este estudio fue conocer la asociación entre PST y PP. Para el estudio, fueron utilizados 752 cefalogramas digitales laterales, obtenidos de los registros archivados de la Facultad de Odontología de la Universidad Necmettin Erbakan, Konya, Turquía. Hubo una relación significativa entre la presencia de PST y PP (p = 0,000, p <0,001). Este estudio indica que existe una correlación significativa entre la presencia de PST y PP.

A morphological study of the dorsum sellae in human skull / Estudio morfológico del dorsum sellae en el cráneo humano

Anatomical variations in the shape and dimension of the dorsum sellae and posterior clinoid process are common. Most textbooks describe its shape as a median rectangular plate, a square plate, or a transverse ledge on a slope behind the sella turcica (hypophyseal fossa). This work aims to study the dorsum sellae of human skull. One hundred and twenty five dried adult human skulls, irrespective of age, were used for the study. Detailed features of the dorsum sellae were noted and classified into five types: crest like, thin plate, frail quadrilateral plate, heavy square plate, thick elongated plate. Fusion of the posterior and middle clinoid processes in one (unilateral) and all the clinoid processes (anterior, middle, and posterior) in three skulls (unilateral in one, bilateral in two) were also noticed. Findings are discussed in the light of the literature.

Son frecuentes las variaciones anatómicas de la forma y dimensión de dorsum sellae y de los procesos clinoides posteriores. La mayoría de los textos describen su forma como una placa rectangular mediana, una placa cuadrada, o un plano transversal en una pendiente detrás de la sella turcica (fosa hipofisaria). Este trabajo tiene como objetivo estudiar el dorsum sellae en cráneo humano. Para el estudio se utilizaron 125 cráneos humanos adultos secos, de diferentes edades. Se observaron características detalladas de dorsum sellae y se clasificaron en cinco tipos: cresta, al igual que la placa delgada, lámina cuadrilátera, placa cuadrada gruesa, placa alargada gruesa. En tres cráneos se observó fusión de la parte posterior y los procesos clinoides intermedios (unilateral) y los procesos clinoides (anterior, medio y posterior) (unilateral en uno de ellos, bilateral en dos). Los resultados se discuten en consideracion de la literatura.

Facial height in Japanese-Brazilian descendants with normal occlusion

OBJECTIVE: The aim of this study was to determine the standards of facial height in 30 young (14-year-old) Japanese-Brazilian descendants with normal occlusion, and assess whether sexual dimorphism is evident. METHODS: The cephalometric measurements used followed the analyses by Wylie-Johnson, Siriwat-Jarabak, Gebeck, Merrifield and Horn. RESULTS: Results showed dimorphism for total anterior facial height (TAFH), lower anterior facial height (LAFH), anterior facial height (AFH), total posterior facial height (TPFH) and upper posterior facial height (UPFH) measurements. CONCLUSIONS: The standards of facial heights in young Japanese-Brazilian descendants with normal occlusion were observed. Sexual dimorphism was identified in five out of thirteen evaluated variables at this age range. .

INTRODUÇÃO: o objetivo desse estudo foi obter os valores médios de normalidade das alturas faciais anterior e posterior de 30 jovens mestiços nipo-brasileiros, descendentes de xantodermas e leucodermas, com oclusão normal, com idade média de 14 anos, e verificar a presença ou ausência de dimorfismo entre os sexos. MÉTODOS: elaborou-se um estudo cefalométrico com as mensurações advindas das análises de Wylie e Johnson, Siriwat e Jarabak, Gebeck, Merrifield e Horn. RESULTADOS: os resultados revelaram a presença de dimorfismo entre os sexos para as variáveis AFAT, AFAI, AFA, AFPT e AFPS. CONCLUSÕES: um padrão cefalométrico específico, das alturas faciais anterior e posterior, para os jovens mestiços nipo-brasileiros com oclusão normal, descendentes de xantodermas e leucodermas, foi apresentado e um dimorfismo entre os sexos para cinco das treze variáveis avaliadas foi verificado nessa faixa etária média. .

Características biométricas de la silla turca en telerradiografías laterales de individuos mapuches y no mapuches de la IX Región, Chile / Biometric characteristics of the sella turcica in lateral telerradiographs of individuals Mapuche and non Mapuche of the IX Region, Chile

El cefalograma lateral es una radiografía que se usa rutinariamente en la ortodoncia. Este tipo de radiografía plana es la mejor opción para investigar las características morfométricas de la silla turca, determinando su tamaño y forma y sus eventuales variaciones. Taveras & Wood han descrito un método, para determinar el tamaño de la silla turca en radiografías. Midiendo el mayor diámetro anteroposterior de la silla turca y la profundidad de ella desde el punto más bajo a una línea que conecta la cima del dorso de la silla al tubérculo selar. Esto nos motivó llevar a cabo un estudio de estas características, para lo cual se registraron las correspondientes observaciones en 88 teleradiografias laterales, de las cuales correspondían a 44 individuos adultos jóvenes mapuches y 44 no mapuches, de ambos sexos, todos pertenecientes a la IX Región. El diámetro anteroposterior de la silla turca fue de 12,85 +/- 1,5 mm, con rangos entre 10,05 a 15,95 mm; la profundidad fue de 10,31 +/- 1,3 mm, con rangos de 7,20 a 13,36 mm; en individuos no mapuche el diámetro anteroposterior fue de 12,11 +/- 2,4 mm, con rangos entre 6,72 a 17,06 mm; la profundidad fue de 11,01 +/- 1,4 mm, con rangos de 7,92 a 13,67 mm. El área selar en mapuches fue de 132,4 mm²; y en no mapuches de 133,3 mm². La forma de la fosa fue circular en 36 casos, oval en 30 casos y plana en 22 casos.

The lateral cephalogram is an x-ray routinely used in orthodontics. This type of plane x-ray is the best choice to investigate the morphometric characteristics of the sella turcica, its size and shape, creating a variation. Taveras & Wood described a method to determine the size of the sella in radiography. Measuring the diameter of the anterior sella turcica and the depth of it from the lowest point to a line connecting the top of the back of the sella to the sellar tuber. This led to a study of the present characteristics , which reported observations in 88 lateral teleradiograph takes, of which 44 were young adult Mapuche individuals and 44 non Mapuche of both sexes, all native to the IX Region. The anteroposterior diameter of the sella turcica was 12.85 +/- 1.5mm, ranging from 10.05 to 15.95 mm, the depth was 10.31 +/- 1.3 mm, with ranges of 7.20 to 13.36 mm, in Mapuche individuals anteroposterior diameter was 12.11 +/- 2.4 mm, ranging from 6.72 to 17.06 mm, the depth was 11.01 +/- 1.4 mm, ranging from 7.92 to 13.67mm. Sellar area in Mapuches has been set at 132.4 mm² and non Mapuche of 133.3 mm². The shape of the fossa of the sella turcica was circular in 36 cases, oval in 30 cases and plane in 22 cases.

The relationship between overjet size and dentoalveolar compensation.

Background : The purpose of this study was to investigate the effect of overjet size and the dento-alveolar compensation in subjects with normal class I molar relationship. Materials and Methods: Lateral cephalometric head records of 59 Egyptian children (34 boys and 25 girls) aged 7.5 to 10.5 years with mean age of 8.69±0.73. All had normal class I type of occlusion. The sample was classified into four quartiles according to the overjet size and the cephalometric analysis was based on seven linear and eight angular measurements using a dental tracer programme. Results: showed that, in spite of presence of high significant over jet size differences between the groups; there was no significant differences in all the studied parameters were found. Applying the least significant differences (LSD) test and coefficient correlations between the studied parameters clarifying that there was a significant differences in angular measurements (SN-AB, SN-Occl, I-I, I-ML, I-NB). Conclusion: during transitional dentition there was a sufficient dento-alveolar adaptation to growth changes in the saggittal jaw relation ship to attain normal class I type of occlusion. This compensation is pronounced in angular parameters and clustered in the lower arches particularly in incisal area.

A study of cephalometric appraisal of the inheritance of craniofacial pattern in Gorkhas.

The phenotypic expression of biologic variability expressed in the craniofacial complex is influenced by constant interplay of heredity and environmental factors. The aim of this study was to observe the pattern of inheritance of cranio-facial complex in Gorkhas. Gorkhas are the original inhabitants of NEPAL in the slopes of HIMALAYAS and they generally marry strictly in their race. 76 individuals from 19 Gorkha families (son, daughter and both parents); were selected. Eight angular (saddle angle, articular angle, gonial angle, N-S-Gn, N-S-Go, SNA, SNB and ANB angles) and four linear (anterior facial height, posterior facial height, overjet and overbite) variables were measured from lateral head cephalograms and the values of the variables were evaluated and compared. It was found that the Inheritance of cranio facial pattern has shown significant coefficient of correlation from mother to offsprings for jarabak ratio, father to son for NS-Gn and NS-Go angle, father to daughter for articular and ANB angles. Different parts of craniofacial complex represents the resultant of morphology and size variation. Each one of these components are in turn influenced by many genetic and environmental factors.

Estudio de las diferentes formas de la silla turca por medio de la tomografía computada / Different morphologyc aspects of sella turcica by computed tomography

El desarrollo de la tecnología en el diagnóstico por imagen hizo posible el análisis morfológico multiplanar de las estructuras intracraneanas, como la silla turca. Para el presente estudio fueron utilizados cien cráneos del Departamento de Anatomía Descriptiva y Topográfica de la Universidad Federal de Sao Paulo (UNIFESP), que después de clasificarlos, fueron sometidos a exámenes tomográficos en el plano sagital, donde los datos radiológicos que se obtuvieron pudieron ser correlacionados de acuerdo con el sexo de los individuos analizados, demostrando que la silla turca es una estructura anatómica constante, pero de forma variable.

Radiological anatomy of the sella turcica and sphenoid sinus

A descriptive, analytic study was conducted among Saudi adult, who presented to two major causalty units, King Fahd Hospital of the University [Al Khobar], and Al Mouwasat Hospital [Dammam]. One hundred skull x-rays of Saudi adults were selected for studying the dimensional and structural anatomy of the sella turcica and the types of sphenoid sinus. The dimensional anatomy of the sella turcica included the length and depth and the structural anatomy classified the shape. The sphenoid sinus was classified according to the degree of pneumatisation. The study material included 50 males and 50 females, with a mean age of 33 years. The mean length of the sella turcica was 12.8 mm and the mean depth was 8.5 mm. Rounded sella turcica was most frequently encountered and seen in 52 individuals, followed by the C-shaped in 29, and the J-shaped sella turcica seen in 19 individuals. None of this adult group had conchal type sphenoid sinus, 37 had pre-sellar types, and 63 individuals had the sellar type sphenoid sinus. This is the first study in Saudi Arabia looking into the normal radiological variation of the sella turcica and sphenoid sinus, in both shape and dimensions, among the Saudi population

Morfometria da sella turcica humana através da tomografia computadorizada e sua relação com o índice crânico horizontal / Morphometry of the sella turcica for computed tomography and your relation with the cranial index

Objetivo: O desenvolvimento da tecnologia em diagnóstico por imagem tornou possível a realização da pesquisa morfológica da sella turcica, objeto desta tese. Imagens tomográficas foram obtidas em diferentes planos de secção, focalizando sua morfometria e sua forma. Os dados radiológicos obtidos foram correlacionados com o índice crânico horizontal (ICH), a idade e o sexo dos indivíduos cujos crânios foram analisados. Métodos: Foram utilizados para este estudo 100 crânios do Museu de Ossos da UNIFESP - Escola Paulista de Medicina, que após mensurados e classificados, foram submetidos a exames tomográficos nos três planos de secção: coronal, transversal e sagital, sendo posteriormente calculadas as seguintes medidas no filme: altura, perímetro, comprimento e área da sella turcica. Estatisticamente foram utilizados os testes qui-quadrado, Mann-Whitney, Kruskal-Wallis e Correlação de Spearman. Resultados: Os valores tomográficos da sella turcica são: comprimento mais freqüente de 10,31 mm variando entre 6 a 15,1 mm; altura mais freqüente de 6,33 mm variando entre 2,9 e 11,1mm; área mais freqüente de 41,21mm` variando entre 8 e 79mm2; perímetro mais freqüente de 30,02mm variando entre 17,44 e 42,12mm. Conclusões: Conclui-se que a sella turcica é uma estrutura anatômica constante, de forma variável, e que se desenvolve independentemente da tipologia craniana nos indivíduos do sexo feminino. Há influência do sexo sobre o comprimento tomográfico da sela e sobre o perímetro tomográfico da sele nos indivíduos masculinos. Há também correlação estatística entre alguma medidas da própria sela: área e perímetro (rs=0,873); área e altura (rs=0,920) área e comprimento (rs=0,292); perímetro e a altura (rs=0,720); comprimento E perímetro (rs=0,649); distância entre os processos clinóides anteriores E posteriores direitos e esquerdos (rs=0,766)

Anatomia microcirúrgica da região selar em cadáveres a fresco utilizando técnica fotográfica com fluoresceína / Microsurgical anatomy of sellar region in fresh cadaveres by photographic technique using fluorescein

Foram estudadas as medidas microcirúrgicas da região selar de 20 cadáveres com um máximo de 12 horas após o óbito. Utilizou-se fluoresceína como contraste para estudo do sistema vascular. O estudo em cadáveres com pouco tempo após o óbito e o uso de fluoresceína objetivaram evitar distorções na anatomia das estruturas causadas pela formolização ou pelo uso de contrastes a base de cola. A droga foi diluída em água ou, para se obter maior consistência, em gel de ultrassonografia. A injeção do contraste foi feita nas artérias carótidas comuns e o registro fotográfico realizado com três diferentes tipos de iluminação: 1) lâmpada de Wood ("luz negra"); 2) lâmpada de wood mais luz branca; 3) luz branca. Obteve-se melhor contraste quando se iluminou somente com a lâmpada de wood. As medidas realizadas mostraram, com frequência, resultados diferentes dos de outros autores. A técnica fotográfica com fluoresceína é simples e acessível, apresentando excelente qualidade como contraste vascular para estudos neuroanatômicos.

Acceso transcraneal subfrontal para el tratamiento quirúrgico de las lesiones periquiasmáticas / The subfrontal approach is utilized in perichiasmatic lesions

Se utilizó el acceso transcraneal subfrontal para el tratamiento de siete pacientes con diagnóstico de lesión periquiasmática (cinco adenomas de hipófisis, un glioma y un aneurisma). Se analizaron las indicaciones y complicaciones inherentes al procedimiento quirúrgico, así como el manejo del seno frontal en aquellos casos en que es abierto durante la craneotomía.

Variaciones anatómicas en la microcirugía de la región selar / Anatomic variation in microsurgery of the sellar area

El presente trabajo muestra las variaciones antómicas de los nervios ópticos, en su longitud desde el quiasma óptico hasta su ingreso en el agujero óptico, las distancias entre los mismos; igualmente nos muestra los diferentes grados de apertura del diafragma selar y las diversas formas que adoptan. Se hace la propuesta de las razones de la invasión supraselar. Se hace la atención en las relaciones vasculares, nerviosas, meníngeas y óseas de la región.