Evaluation of Sella Turcica Bridging and Morphology in Different Types of Cleft Patients

The purpose of this study was to describe the shape and measure the size of the sella turcica in Saudi subjects with different skeletal types. Lateral cephalometric radiographs of 180 individuals (90 males and 90 females) with an age range of 11-26 years were taken and distributed according to skeletal classification; 60 Class I, 60 Class II, and 60 Class III. The sella turcica on each radiograph was analysed and measured to determine the shape of the sella, in addition to the linear dimensions of length, depth, and diameter. A Student's t-test was used to calculate differences in linear dimensions, while a one-way analysis of variance was performed to study the relationship between skeletal type and sella size. The results show that the sella turcica presented with a normal morphology in the majority of subjects (67 per cent). No significant differences in linear dimensions between genders could be found. When age was evaluated, significant differences were found between the older (15 years or more) and the younger (11-14 years) age groups at the 0.01 and 0.001 levels for length, depth, and diameter. Sella size of the older age group was larger than in the younger age group. When skeletal type was compared with sella size, a significant difference was found in the diameter of sella between the Class II and Class III subjects (P < 0.01). Larger diameter values were present in the skeletal Class III subjects, while smaller diameter sizes were apparent in Class II subjects (multiple comparison tests). When gender, age, and skeletal type were all compared with the size of the sella (regression analyses), age was significantly related to a change of length (P < 0.01) and diameter (P < 0.001). Sella shape and dimensions reported in the current study can be used as reference standards for further investigations involving the sella turcica area in Saudi subjects.

The purpose of this study was to establish normative longitudinal cephalometric standards of size and to describe the morphology of the sella turcica in Norwegian males and females between 6 and 21 years of age using standardized lateral radiographic cephalograms. The subjects comprised 35 males and 37 females from the Oslo University Craniofacial Growth Archive. All were healthy Caucasians, with an Angle Class I molar and canine relationship with no apparent facial disharmony. None had undergone orthodontic therapy. The length, depth, and diameter of the sella turcica was measured and the mean values were analysed longitudinally. Comparisons between the dimensions of the sella turcica of males and females in each age group were performed using a Student's t-test. The length of the sella turcica was almost constant throughout the observation period and the depth and diameter increased with age. No differences between males and females were detected for the depth and diameter of the sella turcica, but the length was larger in males throughout the observation period. The morphology of the sella turcica was assessed and five different morphological aberration types were identified: oblique anterior wall, sella turcica bridging, double contour of the floor, irregularity (notching) in the posterior part of the dorsum sellae, and pyramidal shape of the dorsum sellae. The female subjects had slightly more sella turcicas with aberrant morphology. These reference standards for the dimensions of the sella turcica can be used in the study of growth and development of individuals with craniofacial aberrations and syndromes.

To determine the clefting birth prevalence among Asian populations, specifically Chinese and Japanese, using raw counts from nonoverlapping published studies of Asian populations, and to investigate whether Asian clefting rates have been interpreted accurately as being up to twice the Caucasian rate. A literature review of articles giving raw counts of clefting in Asian populations, primarily Japanese and Chinese. Where possible, clefts were identified by the patients' ethnicity, country of origin, cleft type, syndromic status, and birth status. Prevalence rates of cleft lip with or without cleft palate per 1000 live births are reported. Syndromic plus nonsyndromic cleft lip with or without cleft palate: Chinese, 1.30; Japanese, 1.34; Other Asian, 1.47; and total, 1.33. Nonsyndromic cleft lip with or without cleft palate: Chinese, 1.20; Japanese, 1.18; Other Asian, 1.22; and total, 1.19. Overall, Chinese and Japanese live birth prevalence rates for nonsyndromic cleft lip with or without cleft palate, based on the published reports of birth prevalence, are significantly lower than the oft-quoted rate of 2 per 1000 for Asians. The apparent reason for the discrepancy is that many published prevalence rates included all pregnancies (live births plus pregnancy losses) and do not distinguish between syndromic and nonsyndromic clefts or between cleft palate alone and cleft lip with or without cleft palate. These results demonstrate that it is extremely important for current population-based studies of clefts to include careful delineation of population groups, syndromes, cleft type, and birth status.