Cephalometric predictors of abnormal sella turcica among individuals with Sheehan Syndrome: A case-control study

Authors

DOI:

https://doi.org/10.33448/rsd-v10i5.15316

Keywords:

Hypopituitarism; Sella Turcica; Radiography dental digital; Maxillofacial abnormalities.

Abstract

The present study aimed to analyze cephalometric predictors of abnormal sella turcica (ST) in Sheehan Syndrome (SS) patients. An observational case-control study was performed with SS volunteers from the Endocrinology and Diabetology Service of the Walter Cantídio University Hospital (Brazil). The sample was composed of 32 patients allocated in two groups: case group (16 adult women diagnosed with SS) and control group (16 healthy individuals matched by sex and age). Analyzes of the linear dimensions (length, diameter, and depth) of the ST on lateral teleradiographies were made using the Radiocef Studio 2 software. The morphological pattern (anterior oblique wall, double floor contour, bridged, irregularities of the dorsal face, pyramidal) was also assessed. The subjects mean age was 65.47 ± 10.19 years. SS patients had lower mean length (p <0.001), width (p <0.001) and height (p = 0.033) compared to the control group. The presence of morphological alteration of the ST was statistically significant (p = 0.009) compared to the controls. The most frequent morphological changes were irregularities of the dorsal face (37.5%; p = 0.018), oblique anterior wall (12.5%), double floor contour (6.3%), and bridged appearance (6.3%). Our study found smaller dimensions and morphological variations of ST in Brazilian SS individuals, highlighting the importance of ST-related imaging screening.

References

Abdel-Kader, H. M. (2007). Sella turcica bridges in orthodontic and orthognathic surgery patients. A retrospective cephalometric study. Aust Orthod J, 23, 30-5.

Alkofide, E. A. (2007). The shape and size of the sella turcica in skeletal Class I, Class II, and Class III Saudi subjects. Eur J Orthod, 29, 457-63.

Axelsson, S., Storhaug, K.,& Kjaer, I. (2004). Post-natal size and morphology of the sella turcica. Longitudinal cephalometric standards for Norwegians between 6 and 21 years of age. Eur J Orthod, 26, 597-604.

Axelsson, S., Kjaer, I., Heiberg, A., Bjørnland, T., & Storhaug, K. (2015). Neurocranial morphology and growth in Williams syndrome. Eur J Orthod, 27, 32-47.

Bakiri, F., Bendib, S. E., Maoui, R., Bendib, A., & Benmiloud M. (1991). The sella turcica in Sheehan's syndrome: computerized tomographic study in 54 patients. J Endocrinol Invest, 14, 193-6.

Björk, A., & Skieller, V. (1983). Normal and abnormal growth of the mandible. A synthesis of longitudinal cephalometric implant studies over a period of 25 years. Eur J Orthod, 5, 1-46.

Bolanowski, M., Halupczok, J., & Jawiarczyk-Przybyłowska, A. (2015). Pituitary disorders and osteoporosis. Int J Endocrinol, 2015, 206853.

Diri, H., Tanriverdi, F., Karaca, Z. Senol, S., Unluhizarci, K., & Durak, A. C., et al. (2014). Extensive investigation of 114 patients with Sheehan's syndrome: a continuing disorder. Eur J Endocrinol, 171, 311-8.

Freire, M. C. M., & Pattussi, M. P. (2018). Tipos de estudos. IN: Estrela, C. Metodologia científica. Ciência, ensino e pesquisa. 3ª ed. Porto Alegre: Artes Médicas, 109-127.

Friedrich, R. E., Baumann, J., Suling, A., & Scheuer, H. T. (2017). Sella turcica measurements on lateral cephalograms of patients with neurofibromatosis type 1. GMS Interdiscip Plast Reconstr Surg DGPW, 6, Doc05.

Gibbins, K. J., Albright, C. M., & Rouse, D. J. (2013). Postpartum hemorrhage in the developed world: whither misoprostol? Am J Obstet Gynecol, 208, 181-3.

Gokalp, D., Tuzcu, A., Bahceci, M., Arikan, S., Ozmen, C. A., & Cil, T. (2009). Sheehan's syndrome and its impact on bone mineral density. Gynecol Endocrinol, 25, 344-9.

Harris, E. F., & Smith, R. N. (2009). Accounting for measurement error: a critical but often overlooked process. Arch Oral Biol, 54, Suppl 1, S107-17.

Karaca, Z., Laway, B. A., Dokmetas, H. S., Atmaca, H., & Kelestimur, F. (2016) Sheehan syndrome. Nat Rev Dis Primers, 2, 16092.

Kjaer, I., Becktor, K. B., Nolting, D., & Fischer Hansen, B. (1997). The association between prenatal sella turcica morphology and notochordal remnants in the dorsum sellae. J Craniofac Genet Dev Biol, 17, 105-11.

Kjaer, I., Keeling, J. W., Reintoft, I., Nolting, D., & Fischer Hansen, B. (1998). Pituitary gland and sella turcica in human trisomy 21 fetuses related to axial skeletal development. Am J Med Genet, 80, 494-500.

Kjaer, K. W., Hansen, B. F., Keeling, J. W., Nolting, D., & Kjaer, I. (1999). Malformations of cranial base structures and pituitary gland in prenatal Meckel syndrome. APMIS, 107, 937-44.

Kjær, I. (2015). Sella turcica morphology and the pituitary gland-a new contribution to craniofacial diagnostics based on histology and neuroradiology. Eur J Orthod, 37, 28-36.

Korayem, M., & AlKofide, E. (2015). Size and shape of the sella turcica in subjects with Down syndrome. Orthod Craniofac Res, 18, 43-50.

Niswander, J. D. (1967). Cranial morphology in Down's syndrome. A comparative roentgenencephalometric study in adult males. Am J Hum Genet, 19, 180.

Otuyemi, O. D., Fadeju, A. D., & Adesina, B. A. (2017). A Cephalometric analysis of the morphology and size of sella turcica in Nigerians with normal and bimaxillary incisor protrusion. J West Afr Coll Surg, 7, 93-111.

Preston, C. B. (1979). Pituitary fossa size and facial type. Am J Orthod, 75, 259-63.

Sheehan, H. (1937). Postpartum necrosis of the anterior pituitary. J Pathol Bact, 45, 189–214.

Silverman, F. N. (1957). Roentgen standards fo-size of the pituitary fossa from infancy through adolescence. Am J Roentgenol Radium Ther Nucl Med, 78, 451-60.

Suri, S., Tompson, B. D.,& Cornfoot, L. (2010). Cranial base, maxillary and mandibular morphology in Down syndrome. Angle Orthod, 80, 861-9.

Downloads

Published

15/05/2021

How to Cite

CID, A. M. P. L. .; QUIDUTE, A. R. P. .; MARTINS, M. R. A. .; CAVALCANTE, D. de S.; BRITO, G. G.; GURGEL, M. L.; KURITA, L. M.; SILVA, P. G. de B. .; CARVALHO, F. S. R. .; COSTA, F. W. G. . Cephalometric predictors of abnormal sella turcica among individuals with Sheehan Syndrome: A case-control study. Research, Society and Development, [S. l.], v. 10, n. 5, p. e52210515316, 2021. DOI: 10.33448/rsd-v10i5.15316. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/15316. Acesso em: 15 nov. 2024.

Issue

Vol. 10 No. 5

Section

Health Sciences

License

Copyright (c) 2021 Adília Mirela Pereira Lima Cid; Ana Rosa Pinto Quidute; Manoel Ricardo Alves Martins; Davi de Sá Cavalcante; Geibson Góis Brito; Marcela Lima Gurgel; Lúcio Mitsuo Kurita; Paulo Goberlânio de Barros Silva; Francisco Samuel Rodrigues Carvalho; Fábio Wildson Gurgel Costa

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish with this journal agree to the following terms:

1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.