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Significance of sella turcica saddle

  • Category: Health
  • Subcategory: Human Body
  • Topic: Bone
  • Pages: 2
  • Words: 717
  • Published: 28 January 2019
  • Downloads: 17
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The sella turcica is a saddle shaped depression seen in the upper surface of sphenoid bone and is located between the two anterior and two posterior clinoid processes. It is composed of three parts: the tuberculum sellae, pituitary fossa consisting of pituitary gland and the dorsum sellae [1, 2]. Morphological appearance of sella turcica is established in early embryonic structure. Variations in the shape of sella urcica have long been reported by many researchers. The shape of sella turcica was classified in to circular, oval, and flattened or saucer-shaped and majority of the subjects had either a circular or oval shaped sella. Other classifications were based on the contours of the sella floor, the angles formed by the contours of anterior and posterior clinoid processes and tuberculum sellae and the fusion of both clinoid processes as sella turcica bridge [3,4]. There are six main types of sella turcica as investigations: Normal sella turcica, oblique anterior wall, double contoured sella, irregularity (notching) in the posterior part of the sella, pyramidal shape of the dorsum sellae, and sella turcica bridge.

There are literature reports of larger sella turcica in hyper functioning pituitary and smaller ones in hypo functioning pituitary. During embryological development, sella turcica area is the key point for the migration of the neural crest cells to the frontonasal and maxillary developmental fields. Formation and development of the anterior part of the pituitary gland, sella turcica, and teeth share in common, the involvement of neural crest cells, and dental epithelial progenitor cells differentiate through sequential and reciprocal interaction with neural crest-derived mesenchyme.

The probability of the pituitary serving as the functional matrix of sella turcica can be hypothesised based on this.The development of the sella turcica is closely related to that of the pituitary gland, which must be completed before the sella turcica can be formed. A deviation in the development of the pituitary gland may lead to a deviation in the morphology of the sella turcica.

Changes in the size of the sella turcica are related to any pathology in this region. An enlargement in size not accompanied by bony erosion is usually found in the intrasellar adenomas and the empty sella syndrome. Other not so common causes often enlargement may include Rathke’s cleft cysts and aneurysms. Whereas in other diseases like primary hypopituitarism, growth hormone deficiency, and William’s syndrome, a small sella turcica may be seen in.

Forensic significance:

Forensic medical examination of unknown corpses is a complex process of identification . The need for personal identification arises in cases of putrefaction, skeletonization and destruction of corpses when identification is complicated or impossible. Age, race, gender, portrait and other characteristics can be estimated by the examination of the skull, teeth and post cranial skeleton [12,13]. Skeletal remains do not change its n features over time and have sufficient information.

However, the size of the sella turcica, and smaller sella turcica size in particular, may cause pituitary dysfunction because of the changes in the structure of pituitary gland or may be associated with some genetic or acquired endocrine disorders.

In this study, 20 cephalometric radiographs each of males and females belonging to the category of 10-30 years were analysed to identify the difference in morphology between individuals. The sella turcica region was traced on each lateral cephalometric radiography on thin butter paper under ideal lighting. Then, different parts of the sella turcica including tuberculum sella, floor of sella turcica, dorsum sella and anterior and posterior clinoid processes were all traced. The pituitary gland and the sella region were observed from the radiographs. The shape of diaphragm sella was traced and their respective linear measurements were recorded. The data collected includes the length, depth and the anterior posterior diameter of both males and females.

DS – TS = the length (L)

APD TS = Anterior posterior diameter (APD)

L – BPF = Depth of the sella turcica (D)

The length was measured as distance between the dorsum sella to tuberculum sella, the depth was measured as distance from the midpoint of length to base of pituitary fossa and the anterior posterior diameter was measured as the distance between tuberculum sella and the anteroposterior region in the sella turcica.

The statistical analyses was done using the Levine’s test for equality of variants and t-test for equality of means. Therefore, morphometric differences can be analysed in males and females through this study.

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