[Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostischeund Interventionelle Neuroradiologie, Homburg/Saar (Germany) 2009-07-15 Tumors of the pituitary gland can lead to limitation of hypophysis function (hypophysis insufficiency) or hypersecretion of different hormones (acromegaly, Cushing's syndrome, prolactinoma, TSH-secreting adenoma). The optic chiasma lies in close proximity to the pituitary gland and can be compressed by tumors leading to visual disturbances (bilateral hemianopsia). Tumors can be separated into hormone secreting and hormone inactive tumors, as well as into microadenoma with a diameter 10 mm. A rare group of tumors of the hypophysis region are craniopharyngiomas, meningiomas, germinomas, gliomas, metastases and granulomotous inflammations, such as sarcoidosis and tuberculosis. (orig.) [German] Bei Tumoren der Hypophysenregion kann es zu einer Einschraenkung der Hypophysenfunktion (Hypophyseninsuffizienz) kommen, aber auch zu einem Hypersekretionssyndrom (Akromegalie, Cushing-Syndrom, Prolaktinom, TSH-sezernierendes Adenom). Unmittelbar ueber der Hypophysenregion liegt das Chiasma opticum, wodurch es bei Tumoren der Hypophysenregion zur Beeintraechtigung des Sehens kommen kann, meist als Verschlechterung des Sehfeldes beider Augen nach lateral (bitemporale Hemianopsie). Man unterscheidet hormonaktive und -inaktive Tumoren. Full Text Available Die Multidetektor-Computertomographie (MDCT und die Magnetresonanztomographie (MRT haben ihren festen Platz in der Diagnostik. Material und Methodik: 50 Patienten (43 Kinder und Jugendliche, 7 Erwachsene) mit dringendem Verdacht auf eine Innenohrmissbildung erhielten eine. Hochmaligne Gliome und diffus intrinsische Ponsgliome haben eine sehr schlechte Prognose. Erfolgsrezepte existieren nicht. Weitere Tumoren der hinteren Schaedelgrube sind Meningeome, Schwannome, Haemangioblastome, Hirnstammgliome und Epidermoide. Da die verschiedenen Tumoren der hinteren Schaedelgrube unterschiedliche Behandlungsansaetze sowie Prognosen haben, ist eine genaue und spezifische Diagnose obligatorisch. Differentiation between malignant and benign tumors of peripheral nerves in the early stages is challenging; however, due to the unfavorable prognosis of malignant tumors early identification is required. Das Osteosarkom ist der haeufigste maligne Knochentumor v. Bei Kindern und jungen Erwachsenen. Tumors in the region of the sella turcica; Tumoren der Sellaregion Energy Technology Data Exchange (ETDEWEB). [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostischeund Interventionelle Neuroradiologie, Homburg/Saar (Germany). Tumors of the pituitary gland can lead to limitation of. Es werden Mikroadenome mit einem Durchmesser bis 10 mm und Makroadenome, die groesser als 10 mm sind, unterschieden. Eine seltenere Gruppe von Tumoren der Hypophysenregion sind die Kraniopharyngeome, Meningeome, Germinome, Gliome, Metastasen und granulomatoese Entzuendungen (Sarkoidose, Tuberkulose). (orig.) • Kakuno, Yoshiteru; Yamada, Takashi; Hirano, Hiroshi; Mori, Hiroshi; Narabayashi, Isamu 2002-07-01 A 75-year-old man presented with a rare case of chordoma in the sella turcica of the skull base. He had been treated for hypertension and chronic renal failure since 1990. Computed tomography detected a tumor in the sella turcica in 1994, but the patient had no clinical complaints and the serum pituitary hormone levels were normal. He died of disseminated intravascular coagulation, myocardial infarction, pulmonary infection, and multiple cerebral infarctions in 2000. At autopsy, the tumor in the sella turcica was 3.1 cm in greatest diameter and had compressed the pituitary gland posteriorly. Histological examination found oval cells and vacuolated short spindle-shaped cells which showed morphological changes similar to myxoma cells. The tumor was lobulated by narrow connective tissues. The tumor did not contain any cartilaginous tissue components, and was stained positively for epithelial membrane antigen but negatively for S-100 protein. The final diagnosis was chordoma. There was no association between the tumor and the cause of death. • Umarevathi Gopalakrishnan 2015-01-01 Full Text Available The pituitary gland’s role as a functional matrix for sella turcica has not been suggested in orthodontic literature. This paper is an attempt to correlate the role of pituitary gland in the development of sella turcica. A case report of dwarfism associated with hypopituitarism is presented to highlight the above hypothesis. • Gopalakrishnan, Umarevathi; Mahendra, Lodd; Rangarajan, Sumanth; Madasamy, Ramasamy; Ibrahim, Mohammad 2015-01-01 The pituitary gland's role as a functional matrix for sella turcica has not been suggested in orthodontic literature. This paper is an attempt to correlate the role of pituitary gland in the development of sella turcica. A case report of dwarfism associated with hypopituitarism is presented to highlight the above hypothesis. • Umarevathi Gopalakrishnan; Lodd Mahendra; Sumanth Rangarajan; Ramasamy Madasamy; Mohammad Ibrahim 2015-01-01 The pituitary gland’s role as a functional matrix for sella turcica has not been suggested in orthodontic literature. This paper is an attempt to correlate the role of pituitary gland in the development of sella turcica. A case report of dwarfism associated with hypopituitarism is presented to highlight the above hypothesis. • Haritha Pottipalli Sathyanarayana; Vignesh Kailasam; Arun B Chitharanjan 2013-01-01 The sella turcica is a structure which can be readily seen on lateral cephalometric radiographs and sella point is routinely traced for various cephalometric analyses. The search was carried out using the following key words ( sella turcica, bridging of sella, size, shape of sella turcica) and with the following search engine (Pubmed, Cochrane, Google scholar). The morphology is very important for the cephalometric position of the reference point sella, not only for evaluating craniofacial mor. • Becktor, J P; Einersen, S; Kjaer, I 2000-02-01 In earlier studies, a sella turcica bridge was stated to occur in 1.75 to 6 per cent of the population. The occurrence of a sella turcica bridge has not previously been studied in a group of patients with craniofacial deviations treated by surgery. Profile radiographs from 177 individuals who had undergone combined orthodontic and surgical treatment at the Copenhagen School of Dentistry were studied. A sella turcica bridge was registered in those subjects where the radiograph revealed a continuous band of bony tissue from the anterior cranial fossa to the posterior cranial fossa across the sella turcica. Two types of sella turcica bridge were identified. A sella turcica bridge occurred in 18.6 per cent of the subjects. • Brock-Jacobsen, Mette T; Pallisgaard, Carsten; Kjaer, Inger 2009-01-01 of 42 twin pairs (18 male and 24 female pairs, aged 18-23 years) comprised the material. Sella turcica measurements from non-twins aged 6-21 years were used as normal reference. Length, depth and diameter of the sella turcica were measured and controlled by re-measurements. Pearson's correlation. Showed that the size of the sella turcica may be partly similar and partly dissimilar within the pair of monozygotic twins. Statistical evaluation of the data showed correlations between length, depth and diameter of the sella turcica between the two twin individuals in the same twin pair. • Meyer-Marcotty, Philipp; Reuther, Tobias; Stellzig-Eisenhauer, Angelika 2010-04-01 Several investigations have analysed the frequency of sella turcica anomalies in patients with severe craniofacial deviations. Until now, there have been no studies concerning the prevalence of sella turcica bridging in homogenous groups of patients. Therefore, the aims of this controlled study were to analyse the prevalence of sella turcica bridging and measure the size of the sella turcica in two well-defined groups of Caucasian individuals. In a multicentre retrospective study, 400 pre-treatment lateral cephalograms of adult patients (over 17 years of age) with a skeletal Class III (n = 250, 132 females and 118 males) or a skeletal Class I (n = 150, 94 females and 56 males) malocclusion were analysed. The morphology, length, depth, and diameter of the sella turcica were investigated. For statistical analysis, chi-square and t-tests were used. Skeletal Class III patients presented a significantly higher rate of sella turcica bridging, 16.8 per cent (P = 0.031), in comparison with skeletal Class I patients, whose rate was 9.4 per cent. No differences between females and males were detected for the length, depth, and diameter of the sella turcica. Bridging of the sella turcica could be seen radiographically in skeletal Class III subjects. • Kyung, SEE; Botelho, JV; Horton, JC 2014-01-01 Object. The sella turcica usually appears partially empty in MR images obtained from patients with chronic elevation of intracranial pressure. The authors measured the size of the sella turcica to determine if enlargement of the pituitary fossa explains the partially empty sella associated with pseudotumor cerebri. The medical records from 2005 to 2011 of a single neuro-ophthalmologist were searched to identify consecutive patients with pseudotumor cerebri. Age-matched control patien. • Mazumdar, Avi 2006-09-01 The pituitary gland is housed in the sella turcica and has vital endocrinologic functions. It lies in close proximity to numerous vital structures, including the optic chiasm, sphenoid sinus, cavernous sinus and hypothalamus. An understanding of the function, anatomy and embryology of the pituitary gland and its surrounding structures is vital to understanding its normal appearance, as well as in evaluating the broad spectrum of pathology that can involve the pituitary gland. Imaging of pathology in the sellar region, including pituitary adenomas, meningiomas, craniopharyngiomas and aneurysms, plays an important role in guiding treatment decisions. Modern imaging techniques are also important in evaluating the pituitary gland after surgery. • Chang, H-P; Tseng, Y-C; Chou, T-M 2005-09-01 A 28-year-old male presented to the Orthodontic clinic for correction of his anterior crossbite due to mandibular prognathism as a result of pituitary adenoma with acromegaly. A radiographic cephalometric analysis and clinical orthodontic examination were made. This article describes in detail the methods of correcting the magnification of cephalometric linear measurements in sellar dimensions (length, depth and width) from lateral and posteroanterior cephalograms. Cephalometric findings revealed that the sella enlarged in all its dimensions with a deepening of the floor in this acromegalic case. We discuss the radiographic diagnosis of an enlarged sella turcica in intrasellar tumours and also emphasise the dentist's important role in the initial diagnosis of pituitary adenoma cases. • Haritha Pottipalli Sathyanarayana 2013-01-01 Full Text Available The sella turcica is a structure which can be readily seen on lateral cephalometric radiographs and sella point is routinely traced for various cephalometric analyses. The search was carried out using the following key words ( sella turcica, bridging of sella, size, shape of sella turcica and with the following search engine (Pubmed, Cochrane, Google scholar. The morphology is very important for the cephalometric position of the reference point sella, not only for evaluating craniofacial morphology, but also when growth changes and orthodontic treatment results are to be evaluated. This makes it a good source of additional diagnostic information related to pathology of the pituitary gland, or to various syndromes that affect the craniofacial region. Clinicians should be familiar with the normal radiographic anatomy and morphologic variability of this area, in order to recognize and investigate deviations that may reflect pathological situations, even before these become clinically apparent. During embryological development, the sella turcica area is the key point for the migration of the neural crest cells to the frontonasal and maxillary developmental fields. The neural crest cells are involved in the formation and development of sella turcica and teeth. The size of sella turcica ranges from 4 to 12 mm for the vertical and 5 to 16 mm for the anteroposterior dimension. There are many classification systems regarding the shape of sella turcica. Majority of the studies show that about 67% of the subjects had normal appearance and about 33% showed variations. The prevalence of sella turcica bridging is high in class III malocclusions and dental anomalies. • Sathyanarayana, Haritha Pottipalli; Kailasam, Vignesh; Chitharanjan, Arun B 2013-01-01 The sella turcica is a structure which can be readily seen on lateral cephalometric radiographs and sella point is routinely traced for various cephalometric analyses. The search was carried out using the following key words ( sella turcica, bridging of sella, size, shape of sella turcica) and with the following search engine (Pubmed, Cochrane, Google scholar). The morphology is very important for the cephalometric position of the reference point sella, not only for evaluating craniofacial morphology, but also when growth changes and orthodontic treatment results are to be evaluated. This makes it a good source of additional diagnostic information related to pathology of the pituitary gland, or to various syndromes that affect the craniofacial region. Clinicians should be familiar with the normal radiographic anatomy and morphologic variability of this area, in order to recognize and investigate deviations that may reflect pathological situations, even before these become clinically apparent. During embryological development, the sella turcica area is the key point for the migration of the neural crest cells to the frontonasal and maxillary developmental fields. The neural crest cells are involved in the formation and development of sella turcica and teeth. The size of sella turcica ranges from 4 to 12 mm for the vertical and 5 to 16 mm for the anteroposterior dimension. There are many classification systems regarding the shape of sella turcica. Majority of the studies show that about 67% of the subjects had normal appearance and about 33% showed variations. The prevalence of sella turcica bridging is high in class III malocclusions and dental anomalies. PMID:24348611 • Sathyanarayana, Haritha Pottipalli; Kailasam, Vignesh; Chitharanjan, Arun B 2013-09-01 The sella turcica is a structure which can be readily seen on lateral cephalometric radiographs and sella point is routinely traced for various cephalometric analyses. The search was carried out using the following key words ( sella turcica, bridging of sella, size, shape of sella turcica) and with the following search engine (Pubmed, Cochrane, Google scholar). The morphology is very important for the cephalometric position of the reference point sella, not only for evaluating craniofacial morphology, but also when growth changes and orthodontic treatment results are to be evaluated. This makes it a good source of additional diagnostic information related to pathology of the pituitary gland, or to various syndromes that affect the craniofacial region. Clinicians should be familiar with the normal radiographic anatomy and morphologic variability of this area, in order to recognize and investigate deviations that may reflect pathological situations, even before these become clinically apparent. During embryological development, the sella turcica area is the key point for the migration of the neural crest cells to the frontonasal and maxillary developmental fields. The neural crest cells are involved in the formation and development of sella turcica and teeth. The size of sella turcica ranges from 4 to 12 mm for the vertical and 5 to 16 mm for the anteroposterior dimension. There are many classification systems regarding the shape of sella turcica. Majority of the studies show that about 67% of the subjects had normal appearance and about 33% showed variations. The prevalence of sella turcica bridging is high in class III malocclusions and dental anomalies. • Russell, B G; Kjaer, I 1999-11-19 The purpose of this study was to analyze the shape of the sella turcica in a group of patients with Down syndrome and compare the findings with those made earlier in human fetuses with Down syndrome. Profile radiographs from 78 patients (age 4 months to 50 3/12 years) were analyzed. A tracing was made of each sella turcica, and the shape was compared with that of a normal sella, including the normal growth pattern from childhood to adulthood. Sella turcica structure could be classified into three morphological types, defined as: type I, almost normal appearance; type II, deviations in the anterior wall; and type III, deviations in the floor of the sella turcica. Compared with previously registered prenatal structural deviations in the sella turcica, it can be concluded that the postnatal radiographic material reflects the prenatal findings, because type I, both prenatally and postnatally, is by far the most common, whereas the remaining types are uncommon, both prenatally and postnatally. The study confirms the relevance of prenatal investigations for postnatal diagnostics as previously documented in sella turcica analyses of prenatal and postnatal myelomeningocele cases. • Matsui, T.; Ueno, I.; Miki, Y.; Fuchinoue, T.; Kobayashi, N. 1984-01-01 A flattened sella turcica, not previously reported, was found incidentally in a 21-year-old male. Various neuroradiological and hormonal examinations have proved it to be a normal varient. Subsequently a normal pituitary gland was shown by CT. • Leonardi, Rosalia; Barbato, Ersilia; Vichi, Maurizio; Caltabiano, Mario 2006-12-01 Calcification of the interclinoid ligament (ICL) of the sella turcica, or sella turcica bridging, has been associated with severe craniofacial deviations. Despite no comprehensive study on the sella turcica bridge, a relationship with tooth and eruption disturbances has been reported. In order to investigate whether congenital absence of the second mandibular premolar, or the presence of a palatally displaced canine (PDC), is associated with sella bridging, a retrospective study was performed. Lateral cephalometric radiographs from 20 males and 14 females, aged between 8 and 16 years, with a PDC and second mandibular premolar aplasia were reviewed and compared with a control group. A standardized scoring scale was established to quantify the extent of a sella turcica bridge from each radiograph (no calcification, partially calcified, and completely calcified). The prevalence of complete calcification of the ICL in adolescents with dental anomalies was equal to 17.6 per cent, while an incidence 9.9 per cent was found in the control group. A partially calcified sella turcica was observed in 58.8 per cent of adolescents with dental anomalies compared with 33.7 per cent in the control group. The association between the degree of calcification of the ICL and the presence of dental anomalies in the studied adolescents was statistically significant according to chi-square statistics (P = 0.004). This was confirmed by Fisher's exact test (P = 0.003). According to these findings, the prevalence of a sella turcica bridge in adolescents with dental anomalies is increased, while age and gender do not greatly influence ossification of the ICL. The very early appearance during development of a sella turcica bridge should alert clinicians to possible tooth anomalies in life later. • Xu, Hongzhi; Qin, Zhiyong; Shi, Zhenhua 2011-10-01 Chondromyxoid fibroma (CMF) is an uncommon tumor that primarily develops in the long bones of young males. It is rarely seen in the skull and involvement of the skull base is rare. We report a patient with CMF arising in the region of the sella turcica. A literature review regarding the clinical and histological features of CMF, as well as recommended modalities of treatment, is presented. A 55-year-old male was admitted with polyuria and headache. A CT scan showed a well-defined expansive lesion with a sclerotic margin measuring approximately 2 cm in diameter in the sellar region. T1-weighted MRI revealed a well-circumscribed, lobulated and strongly enhancing lesion. On the T2-weighted MRI, the lesion showed high heterogeneous signal intensity. Using the trans sphenoidal approach, surgical exploration revealed a well-defined tumor underneath the optic chiasm. The piecemeal tumor removal was considered complete. We conclude that sellar region CMF can cause severe disabilities due to tumor compression. CMF should be taken into consideration in the differential diagnosis of a solitary tumor mass in the sellar area. As much as possible, surgical resection of the tumor is the cornerstone of treatment. Although CMF are generally regarded as benign neoplasms, they may show an infiltrative pattern and may recur; particularly when they are in locations where complete surgical excision may be difficult or impossible. • Choi, Wook Jin; Hwang, Eui Hwan; Lee, Sang Rae [Kyung Hee Univ. College of Dentistry, Seoul (Korea, Republic of) 2001-03-15 To investigate the shape and size of normal sella turcica on cephalometric radiograms. Cephalometric radiograms of 200 orthodontic patients of age ranging 6-42 years were examined. All subjects were divided into 5 groups by age, the dimensional change of sella turcica was examined according to age, and the configurations of sella turcica floor, tuberculum sella, and anterior and posterior clinoid process were also observed. The contours of sella turcica floor were flat type in 54% and concave type in 46%. The contours of tuberculum sella were right angle type in 55% and obtuse angle type in 44%; Acute angle type and plane type were very rare comprising 0.5%, 0.5% each. The configurations of anterior clinoid process were point type in 80% and round type in 20% of cases, and those of posterior clinoid processes were point type in 60% and round type in 40% of cases. The dimensional change of sella turcica according to age range had significantly positive linear trend to sella turcica length, height, and width until 25 years. After 26 years, no significant increase was found in sella turcica dimension. Especially, the sella turcica length had more proportional increase than that of sella turcica height and width. The results of this study revealed that the configuration of normal sella turcia was variable and the dimensional change of normal sella turcica had a linear tendency with age until 26 years. • Kjaer, I; Keeling, J W; Reintoft, I; Hjalgrim, H; Nolting, D; Fischer Hansen, B 1998-02-26 The purpose of this study was to elucidate the phenotypic conditions in the sella turcica/pituitary gland complex in human trisomy 18 fetuses. Fourteen human fetuses with gestational ages from 12 to 39 weeks were included in the study. Normal fetuses at corresponding ages were used as controls. Whole body and special radiographic examination was undertaken before the midsagittal cranial base block, including the pituitary gland, was excised and analyzed histologically and immunohistochemically (keratin wide spectrum [KWS], thyroid-stimulating hormone [TSH], and neurophysin [Nph]). In all trisomy 18 fetuses, TSH-positive adenopituitary tissue was present in the sella and in greater or lesser amounts pharyngeally. The neurohypophysis was Nph-positive and located normally in the sella turcica. The adenohypophyseal tissue reacted either KWS-faint or KWS-negative, whereas KWS-positive reaction occurs in normal fetuses. This circumstance might suggest an altered cytoskeletal structure of the surface ectoderm in the pituitary placode in trisomy 18. The sella turcica was malformed in all the fetuses. Very broad craniopharyngeal canals were observed in some of the fetuses. Because endocrine disorders occur in many congenital malformations, it is essential in future studies to chart the sella turcica/pituitary gland region systematically in different genotypes. • Andredaki, M; Koumantanou, A; Dorotheou, D; Halazonetis, D J 2007-10-01 The purpose of this study was to use quantitative methods to measure the size and shape of the sella turcica and thus establish normative reference standards that could assist in a more objective evaluation and detection of pathological conditions. Standardized lateral cephalograms of 184 healthy Greeks (91 males and 93 females) were used. The age range was between 6 and 17 years. Conventional measurements included three different heights of the sella turcica (anterior, posterior, median), its length, and width, measured in relation to the Frankfort reference line. In addition, the area of sella turcica was calculated. Morphometric methods were used to assess shape. The tracings were superimposed using the Procrustes method, and the average shape was computed. Principal component analysis (PCA) was used to assess shape variability. The data were correlated with centroid size, age, and gender. Unpaired t-tests were used to determine gender differences. Sella height anteriorly was the only variable found to be significantly different between the genders, being larger in females by 0.5 mm. Linear and area measurements were found to be significantly correlated with age, but all correlations were low (r(2) below 8 per cent). Sella turcica shape, as described by PCA, was different between males and females, mainly at the posterior aspect of the sella outline. However, although there was an extensive overlap between the genders, and differences were minimal. Age was not found to be correlated with the shape coefficients, although, in the female group, the first principal component of shape was marginally not significant. Allometry was observed in both genders, the sella showing a tendency towards a flatter and wider shape with increase in size. The results of this study constitute quantitative reference data that could be used for objective evaluation of sella shape. • Kerr, P Benjamin; Oldfield, Edward H 2008-07-01 In this paper the authors describe the sublabial-endonasal-transsphenoidal approach to the sella turcica, a modification that combines elements of the sublabial-submucosal-transseptal approach and the endonasal approach. It provides a midline, or near midline, trajectory, wide exposure of the sella, and secure speculum placement on the osseous edge of the pyriform aperture, while avoiding dissection of the nasal mucosa, and it can be used for microscopic and endoscopic surgery. • Sidibe, E H 2006-09-01 A 43-year-old patient, known for infertility for ten years, presented hypogonadism (low libido, impotence, low testosteronemia) with hypergonadotropism (high FSH contrasting with low LH) and a tumor syndrome of the sella turcica. The biological, immunohistochemical and clinical features of gonadotropic adenoma are presented. • Brock-Jacobsen, Mette T; Pallisgaard, Carsten; Kjaer, Inger 2009-12-01 The purpose was to compare the sella turcica morphology of individuals within pairs of monozygotic twins with normal karyotype and to analyze the similarity between the observed morphology and the morphology of non-twins at the same age with normal karyotype. Profile radiographs from 84 individuals of 42 twin pairs (18 male and 24 female pairs, aged 18-23 years) comprised the material. Sella turcica measurements from non-twins aged 6-21 years were used as normal reference. Length, depth and diameter of the sella turcica were measured and controlled by re-measurements. Pearson's correlation coefficient was used for comparison of individuals within twin pairs. For comparison of twins and non-twins, normal standard values for length, depth and diameter were subtracted from the twin values. For the mean values of these differences, confidence limits p values and t values were calculated. The study showed that the size of the sella turcica may be partly similar and partly dissimilar within the pair of monozygotic twins. Statistical evaluation of the data showed correlations between length, depth and diameter of the sella turcica between the two twin individuals in the same twin pair. Differences in sizes are observed between individuals in the twin material and individuals in the non-twin material. As a conclusion, the twin males were more similar within the twin pair, but deviated more from the non-twin material than the females. Female twins had more discrepancy within the twin pair, but deviated less from the non-twin material than the males. • Ashraf Mohamed Elsayed Ali SAKRAN *1, Mohammad Afzal KHAN 2, Faris Mohammed Nour ALTAF 3, Hassan Elsiddig Hassan FARAGALLA 4, Amal Yousif Ahmed Elhaj MUSTAFA 5, Muhammad Mazhar HIJAZI 6, Rayan Abdulshakur NIYAZI 7, Abrar Jamal TAWAKUL 8, Abeer Zubair MALEBARI 9, Amal AbdulAziz SALEM 10. 2015-03-01 Full Text Available Background and objective: Precise anatomical knowledge of the sella turcica is important for neurologists and surgeons operating in the region of cavernous sinus or the surrounding structures. The current study was undertaken to record normal morphometric parameters for future reference and to determine if there is any significance difference in the sella turcica morphometry regarding the gender. Methodology: A Morphometric analysis of the Sella Turcica and structures in vicinity were done in thirty six adults’ formalin fixed cadaver's skulls (22 male and 14 female. Results: The pituitary stalk positions were middle in majority of male cases (72.7%, the remaining 27.3% were posterior. Among female; 57.1% were middle and the remaining 42.9% were posterior, no anterior position was detected among both genders with no different between male and female (p = 0.494 Normal Optic chiasma position was detected in all female cases and in 63.6% of male cases with no significant differences regarding gender (p= 0.070. No significant different in diaphragma sella shape and opening regarding gender (p.value = 0.170 and 0.914 respectively No significant difference between males and females concerning linear dimensions of sella turcica (length, depth and Anteroposterior diameters. Concerning diaphragma sella opening; no significant different regarding gender in transverse diameter (p.value= 0.316 while significant different was detected in anteroposterior diameter (p.value= 0.046 For interclinoid (anterior, posterior diameters, which represented statistically significant different regarding gender in both right and left sides (p.value = 0.004 and 0.001 respectively. Conclusion: The current study will provide normal morphometric data for future reference and further studies. • Axelsson, Stefan; Storhaug, Kari; Kjaer, Inger 2004-12-01 Williams syndrome (WS) is a rare congenital disorder with distinctive craniofacial features, cardiovascular abnormalities, mental retardation, and behaviour characteristics. The purpose of this study was to investigate the size and morphology of the sella turcica on profile cephalograms in a group of individuals with WS. The material consisted of radiographic cephalograms of 62 Norwegian children, adolescents, and adults with an age range of 4.7-44.4 years. The length, depth, and diameter of the sella turcica were measured and the mean values were compared with normal reference material from the Oslo University Craniofacial Growth Archive. In total, the two-dimensional size of the sella turcica in the WS group was smaller in length, depth, and diameter compared with the control group, but only occasionally reached a significance level of 5 per cent (Student's t-test). The morphology of the sella turcica was assessed and five different morphological types were identified; oblique anterior wall, extremely low sella turcica, sella turcica bridging, irregularity (notching) in the posterior part of the dorsum sellae, and pyramidal shape of the dorsum sellae. The occurrence of these morphological types was more frequent in the WS subjects compared with the reference material, except for sella turcica bridging, which was equally frequent. The females with WS had more dysmorphic sella turcicas than males. This study has demonstrated morphological aberrations in the sella turcica in Norwegian individuals with WS, which should be further elucidated in future research and combined with neurological andendocrinological investigations. • Rai, Ashwin R; Rai, Rohan; Pc, Vani; Rai, Rajalakshmi; Vadgaonkar, Rajanigandha; Tonse, Mamatha 2016-07-01 Familiarity with the shape and dimensions of sella turcica is important to recognize and manage pathological conditions of pituitary gland as well as for orthodontic treatment planning. The present study aims to describe the morphology and dimensions of sella turcica from Indian population, using lateral cephalograms to set a reference data for comparison among different races. The study used 36 lateral skull radiographs of both sexes between age group of 13 to 18 years. Shape of sella turcica was noted by visual inspection. Length, height anterior, height median, height posterior, distance between frontonasal suture and mental spine to midpoint of posterior clinoid process, and tuberculum sella were measured using digital vernier caliper with reference to Frankfort line. The results of the study revealed that mean length, height anterior, height median, height posterior were larger in females than in males. The morphological types identified include pointed posterior clinoid process with rounded hypophyseal fossa, hooked posterior clinoid process with rounded hypophyseal fossa, hooked posterior clinoid process with flask-shaped hypophyseal fossa. These observations would be beneficial for the clinicians and orthodontists to design treatment planning in pathology of pituitary gland and in correcting dentofacial anomalies. • Paroder, Viktoriya; Miller, Todd; Cohen, M Michael; Shanske, Alan Lawrence 2013-10-01 Absent sella turcica is an extremely rare and dramatic radiographic finding. It may be isolated or occur in the presence of other anomalies, often involving the adenohypophysis. Our evaluation of a female infant with multiple anomalies including absence of the sella turcica, a normal pituitary in the craniopharyngeal canal, normal pituitary function, choanal atresia and anomalies of the appendiceal skeleton prompted a review of the occurrence and biology of an absent sella turcica. • Huang, Benjamin Y; Castillo, Mauricio 2005-07-01 While pituitary adenomas make up over 90% of all sellar masses, there are a number of less known tumors, both malignant and benign, which may arise within the sella turcica. These include relatively common tumors such as meningiomas and craniopharyngiomas, as well as extremely rare tumors such as pituitary astrocytomas and granular cell tumors. Unfortunately, many of these tumors lack characteristic imaging features, often making it extremely difficult to distinguish them by imaging alone from the more common pituitary adenoma. In this article, we review several nonadenomatous tumors of the sella, with a focus on their clinical features and typical MR imaging characteristics. • Leonardi, Rosalia; Farella, Mauro; Cobourne, Martyn T 2011-08-01 The aim of the present study was to determine any association between tooth transposition and bridging of the sella turcica, given the evidence of common embryonic origins associated with these structures and a genetic basis underlying these two conditions. Clinical records of subjects demonstrating dental transposition and normal controls were collected from several hospital orthodontic departments and specialist orthodontic practices. All cases and controls were documented with good quality lateral cephalometric radiographs and dental panoramic tomograms (DPTs). The study sample consisted of 21 Caucasian subjects (7 males and 14 females; mean age 14.5 years; SD 2.2 years), demonstrating either maxillary or mandibular dental transposition. The control group, matched for age and gender to the study sample, comprised 70 Caucasians (31 males and 39 females; mean age 13.8 years; SD 1.8 years) without dental anomalies randomly selected from subjects referred for orthodontic treatment within the same departments. The extent of sella turcica bridging was quantified from each profile radiograph using comparative measurement of length and diameter. Sella turcica bridging was found more frequently in subjects diagnosed with dental transposition than in the controls, with the difference being statistically significant [chi-square=7.4; degrees of freedom (df)=2; P=0.025; Fisher's exact test; P=0.042]. The increased frequency of complete and partial bridging of the sella turcica in subjects with dental transposition provides further evidence of a genetic basis to this condition. As calcification and bridging of this region can present during early childhood, it may act as a useful diagnostic predictor of susceptibility to local dental problems. • Skrzat, Janusz; Mroz, Izabela; Marchewka, Justyna 2012-01-01 This paper presents anatomy and topography of the inconstant osseous bridges that may occur in the sella turcica region. The interclinoid bridge and the caroticoclinoid bridge can be formed in consequence of abnormal ossification of the dural folds or disturbances in development of the sphenoid bone. Their presence may be of clinical importance because of potential influence on the neurovascular structures passing in the vicinity of the clinoid processes of the sphenoid bone. • Inoue, Tomoo; Takahashi, Noboru; Murakami, Kensuke; Nishimura, Shinjitsu; Kaimori, Mitsuomi; Nishijima, Michiharu 2009-01-01 A 29-year-old man presented with a primary sellar turcica osteochondroma manifesting as intratumoral hemorrhage mimicking pituitary apoplexy. The patient suffered sudden onset of headache concomitant with vision loss in the left eye. Radiography and computed tomography detected destruction and calcification of the sellar turcica. Magnetic resonance imaging revealed a heterogeneously enhanced suprasellar mass that had elevated and compressed the optic chiasm. The preoperative diagnosis was hemorrhagic pituitary adenoma, craniopharyngioma, meningioma, or chordoma based on the signal heterogeneity of the lesion. To relieve the symptoms and make a definitive diagnosis, surgical removal via a basal interhemispheric approach was carried out. The tumor was not totally removed because of tight adhesion to the pituitary stalk, but postoperative ophthalmological examination revealed improvement of the visual disturbance. The histological diagnosis was osteochondroma based on the presence of mature chondrocytes and osteomatous tissue. Osteochondroma should be included in the differential diagnosis of tumors with acute hemorrhage in the sella turcica. • Shimizu, Kiyoharu; Tominaga, Atsushi; Kinoshita, Yasuyuki; Usui, Satoshi; Sugiyama, Kazuhiko; Kurisu, Kaoru 2013-10-01 A 64-year-old male presented with an incidental tumor in the sella turcica during a brain medical checkup. Because he lacked any neurological symptoms or signs of pituitary dysfunction, the patient did not undergo surgery. Three years later, visual disturbances developed, including poor eyesight and visual field defects. The response to the growth hormone(GH)releasing peptide-2 demonstrated severe GH deficiency. MRI revealed an enlarged tumor appearing as a mosaic pattern of high and very low intensity on T2-weighted imaging. The region of very low intensity on T2-weighted imaging exhibited enhancement after T1 gadolinium-DTPA administration. The tumor was totally removed via the microscopic trans-sphenoidal approach in combination with endoscopic observation. The hard tumor adhered to the dura of the sella turcica and the medial wall of the left cavernous sinus. Histological verification confirmed a solitary fibrous tumor(SFT). Fourteen months after the operation, MRI revealed no recurrent tumors. SFT infrequently occurs in the sella turcica; however it should be included in the differential diagnosis in cases of enhanced tumors with marked low intensity on T2-weighted imaging. • Yilmazlar, Selcuk; Kocaeli, Hasan; Cordan, Teoman 2004-01-01 A case of metastasis to the sella turcica from a follicular adenocarcinoma of the thyroid gland is presented. Metastasis to this site is rare and review of the literature reveals only 12 cases of metastatic thyroid carcinoma involving the sella turcica and pituitary gland. The optimal treatment strategy is still to be determined. A 43-year-old woman presented with headache, nausea, visual impairment and galactorrhea. An MRI scan of the cranium revealed an enhancing destructive sellar lesion. The patient underwent transsphenoidal removal of the lesion to alleviate visual loss. The histological features of the sellar tumor were identical to those of a follicular adenocarcinoma partially removed from the thyroid gland 22 months earlier. Total thyroidectomy followed by three courses of iodine-131 ablation enhanced with synthetic thyrotropin and thyroid hormone suppression therapy was instituted. The post-operative course was satisfactory with improved vision and ceased galactorrhea. This case was successfully treated with a combination of surgical removal, iodine-131 ablation and hormone suppression therapy, which resulted in disease control duration of four years. Sella turcica metastases of thyroid carcinoma are exceedingly rare and currently there are no established therapeutic guidelines. • Pittayapat, Pisha; Jacobs, Reinhilde [University Hospitals Leuven, University of Leuven, Leuven (Belgium); Odri, Guillaume A. [Service de Chirurgie Orthopedique et Traumatologique, Centre Hospitalier Regional d' Orleans, Orleans Cedex2 (France); De Faria Vasconcelos, Karla [Dept. Of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Sao Paulo (Brazil); Willems, Guy [Dept. Of Oral Health Sciences, Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, University of Leuven, Leuven (Belgium); Olszewski, Raphael [Dept. Of Oral and Maxillofacial Surgery, Cliniques Universitaires Saint Luc, Universite Catholique de Louvain, Brussels (Belgium) 2015-03-15 This study was performed to assess the reproducibility of identifying the sella turcica landmark in a three-dimensional (3D) model by using a new sella-specific landmark reference system. Thirty-two cone-beam computed tomographic scans (3D Accuitomo 170, J. Morita, Kyoto, Japan) were retrospectively collected. The 3D data were exported into the Digital Imaging and Communications in Medicine standard and then imported into the Maxilim software (Medicim NV, Sint-Niklaas, Belgium) to create 3D surface models. Five observers identified four osseous landmarks in order to create the reference frame and then identified two sella landmarks. The x, y, and z coordinates of each landmark were exported. The observations were repeated after four weeks. Statistical analysis was performed using the multiple paired t-test with Bonferroni correction (intraobserver precision: p50% precision in locating the landmark within 1 mm. A newly developed reference system offers high precision and reproducibility for sella turcica identification in a 3D model without being based on two-dimensional images derived from 3D data. • Puja Chauhan; Sunita Kalra; Shashi M. Mongia; Sadakat Ali; Anurag Anurag 2014-01-01 Background: The purpose of this study was to describe the morphology and measure the size of the sella turcica in North Indian population. Methods: Lateral cephalometric radiographs of 180 individuals (90 males and 90 females) with an age range of 12 - 65 years were taken. Morphology of sella turcica was studied and various measurements were taken to determine the shape of the sella. Statistical analysis was done to calculate differences in dimensions and to establish if any, relationship. • Mohamadi, Yousef; Mousavi, Mahboubeh; Pakzad, Reza; Hassanzadeh, Gholamreza 2016-09-01 The pituitary gland is located in the sella turcica. Pituitary tumors constitute approximately 15% of intracranial benign tumors. 'Endo nasal endoscopic trans-sphenoidal' method is an appropriate surgical technique to remove this tumor. In this operation an endoscope enters the nasal cavity through the nostril to reach the floor of the sella turcica. The aim of this study was an anthropometric evaluation of the route of endoscope in this surgery. Two hundred twenty-seven patients (116 women, 111 men) were divided into ≥30, 31 to 61, and ≥61-year age groups. Lateral scanograms of skull were used to measure 3 linear distances and 1 angle. While the mean of the linear variables was significantly higher in men (P. • Louis, O.; Bette, L.; Noseda, A. 1986-01-01 Lens irradiation measurements were performed with thermo-luminescent lithium fluoride dosimeters during tomographic examinations of the sella turcica, simulated on a phantom head. Lens dosimetry during linear or hypocycloidal conventional tomography was compared with that during computed tomography (CT). Results showed that CT involved much lower radiation exposure to the lens than did conventional tomography and that the major part of the irradiation delivered by CT was related to axial scanning. Therefore, the major finding was that lens irradiation during CT of the sella can be kept at a particularly low level (. Significance of the EEG in the diagnosis of epilepsy Summary The electroencephalogram (EEG) is a specific diagnostic method for the evaluation of patients with epilepsies. Interictal epileptiform discharges (IED) recorded in the seizure interval have a high association with the clinical diagnosis of epilepsy. IEDs have to be differentiated from normal variants that resemble IEDs. The EEG may help in the localization of the epileptogenic zone and in the syndrome classification, which is important for therapy and prognosis.
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