A small sella turcica may be associated with pituitary insufficiency, but the correlation is poor [1] and most small sellas are of no significance. The pituitary gland normally sits within the sella. Sella Turcica – Upright Lateral 6. Walter Kucharczyk and Marieke Hazewinkel. Although any tumor can metastasize to the pituitary gland, carcinomas of the breast and lung account for 50% and 20% of cases respectively, based on a review of 220 cases by McCormick et al. The length of the fossa was more influenced by variations in the posterior measurement than in the anterior measurement. Anatomy of the Sella Turcica The anterior, posterior, and inferior walls of the sella turcica are bony while the lateral walls and roof are made of dura that slings between the anterior and posterior clinoid processes. However, in the first six weeks of life the anterior pituitary is bright as well on T1-weighted images in 82% [3]. It extends from the tuberculum sellae to the posterior clinoid processes and dorsum sellae and covers the sella turcica and pituitary gland within 1. Anatomically, the sella turcica has been expressed as variable. Surgery may be warranted. Criteria The sella turcica is visualized without rotation or tilt as indicated by the following: - Sella turcica and clivus are demonstrated in profile. 11, No. These techniques are limited because they do not necessarily reflect true pituitary size. 414, The British Journal of Radiology, Vol. An area greater than 130 mm2, and a volume greater than 1092 mm3, have been reported to be abnormal [2]. Sella turcica: A depression in the base of the skull where the pituitary gland is situated. 5. The sella turcica is a bony depression in the sphenoid bone. The dorsum sellae is part of the sphenoid bone in the skull.Together with the basilar part of the occipital bone it forms the clivus.. The sella and surrounding processes were removed in toto and the soft tissues dissected from the bone. Empty sella syndrome, in contrast, is merely a description of what is seen on an imaging study, and there is no typical set of clinical signs or symptoms associated with this imaging finding. Copyright © 2021 Elsevier B.V. or its licensors or contributors. Although variations exist, the sella turcica generally should not exceed an anteroposterior dimension of 16 mm or a vertical depth of 12 mm on a lateral skull radiograph. The above photos are from young rats ranging from 2.5 – 8 weeks of age. Pituitary tumour, most common cause of enlargement of the sella turcica, the bone cavity in the head in which the pituitary gland is located. The sella turcica is a bony depression in the sphenoid bone. 21, No. The sella is covered by a dural reflection (i.e., diaphragma sellae) above which lies the suprasellar cistern. The sella turcica is a bony depression in the sphenoid bone. It divides the middle cranial fossa in the medial plane into a right and a left half. Sella Turcica and Parasellar Region. Hurler disease is associated with elongation of the posterior aspect of the sella, creating a J-shaped configuration. It lies in a small depression called the sella turcica which is Latin for “Turkish saddle”. We use cookies to help provide and enhance our service and tailor content and ads. According to Taveras and Wood [1], 17 mm is the upper limit of normal for the maximum anteroposterior diameter of the sella. 35, No. 19.1).1 Autopsy studies confirm the high disease prevalence reported to be 5.5% to 20% of the general population.2 Not surprisingly, many patients who undergo brain imaging will have a partially empty sella. The dimensions of the sella turcica in normal, specimens were measured in the antero-posterior, vertical, and transverse directions. Focal erosion of the lateral margins secondary to an aneurysm, focal erosions of the floor by pituitary lesions, and selective erosion of the posteroinferior floor secondary to chronic increased intracranial pressure [3,4] are some of the more dependable findings. The cavernous sinus is located on either side of the sella turcica and superior to the sphenoid bone. The gland itself is composed of an anterior lobe, intermediate (vestigial) and posterior lobe. A parallel study of the roentgen anatomy of the sella turcica and the histopathology of the pituitary gland in 205 autopsy specimens Neuroradiology, Vol. 27, No. The sella turcica ("Turkish saddle") is a concave, midline depression in the basisphenoid that contains the pituitary gland (also called the hypophysis). This review is based on a presentation given by Walter Kucharczyka and was adapted for the Radiology Assistant by Marieke Hazewinkel. Posterior to the sella are the posterior clinoid processes, dorsum sellae, and interpeduncular cistern containing the basilar apex and cranial nerves III and IV. 39, No. Hypophyseal fossa – the deepest part of the sella turcica, where the pituitary gland is located. The name goes back to the Belgian anatomist and professor of anatomy and surgery Adriaan van den Spieghel (1578 - 1625). Treatment entails supporting the patient and addressing any associated endocrine dysfunction present. The cavernous sinus is made up of very thin walled veins that make up a venous plexus. 4, 13 September 2009 | The European Journal of Orthodontics, Vol. Study of the shape of the sella turcica and the bony density of its margins, are limited in their value as predictors of pituitary and/or parasellar disease. Subcranial Relationships The pituitary gland and sella are located in the cranial base below the center of the brain (Fig. Radiology department of the University of Toronto, Canada and the Radiology department the Medical Centre Alkmaar, the Netherlands. Its most important value is its relative stability, practicality and the ease of location of both points Sella and Nasion. In cases in which surgery showed a microadenoma, and in which tomograms were considered positive, the correlation between the actual location of the lesion and the radiographic findings was quite poor. Fitzgerald also concluded that there was an inverse ratio between the length of the fossa and the anterior measurement of the base. The pituitary gland is thus situated in almost the centre of the cranial cavity. Jeffrey A. Hashim, Juan E. Small, in Neuroradiology, 2019, The empty sella turcica was first described in 1949 as a condition where the sella turcica is only partially filled by the pituitary gland, which appears flattened against the sellar floor (Fig. However, commonly reported clinical symptoms include nontraumatic CSF fluid rhinorrhea, irregular menstruation, fatigue, visual disturbances, headaches, and pituitary hyposecretion or hypersecretion. Sharon E. Oberfield MD, ... Daniel Esten Hale MD, in Pediatric Secrets (Fifth Edition), 2011. The posterior surface of attached with membrane, which is termed as dorsum sellae amd the anterior order is attached with the tuberculum sellae. and the average anterior and posterior depth measurements to be 0.70 and 0.78 cm., respectively. The gland itself is composed of an anterior lobe, intermediate (vestigial) lobe, and posterior lobe. At this stage of development the pituitary gland is small and pale pink in color. The sella turcica is a bony depression in the sphenoid bone. The bony spine was 4.35 mm long and protruded from the dorsal side of the pituitary fossa into the fossa itself. Enter your email address below and we will send you the reset instructions. An enlarged sella turcica is a significant finding, suggesting the presence of a pituitary neoplasm, empty sella syndrome, extrapituitary neoplasm, or possibly a normal variant of the patient's anatomy. If the address matches an existing account you will receive an email with instructions to reset your password. Ray N. Conley, Gary A. Longmuir, in Clinical Imaging (Third Edition), 2014. The two can be differentiated on imaging because the posterior lobe characteristically demonstrates increased T1 signal on unenhanced images while the anterior lobe is isointense to gray matter on T1-weighted images. The sella turcica is an indentation in the sphenoid bone at the base of your skull that holds the pituitary gland. The two can be differentiated on imaging because the posterior lobe characteristically demonstrates increased T1 signal on unenhanced images, while the anterior lobe is isointense to gray matter on T1-weighted images. Meningiomas frequently calcify, and on rare occasions pituitary tumors calcify (pituitary stone). 1, Orthodontics & Craniofacial Research, Vol. Unfortunately this has not withstood the close scrutiny of subsequent carefully performed radiologic/pathologic/surgical studies [3,4]. Sella Turcica is a bony cavity housing the pituitary gland, which is located in the brain and responsible for secreting a number of hormones. Anteroinferiorly, the foramen rotundum conducts V2 (maxillary division of trigeminal nerve). Do cervical spine X-rays for trauma have clinically significant incidental findings? The average length of the sella is 10.5 mm and a range of 5 - 16 mm and an average width of 14.0 mm and a range of 10 - 16 mm. This has been referred to as the empty sella syndrome (Figs. Sellar width is defined as the wid… antidiuretic hormone (ADH)). Initial enthusiasm emphasized visualization of small areas of sella floor erosion and/or depression. Metastases are also the most frequent tumor of the eurohypophysis, which is affected about twice as often as the adenohypophysis. The pituitary gland normally sits within the sella. An empty sella can be completely asymptomatic. THE roentgenologic interpretation and significance of changes, in and about the sella turcica are so dependent on an accurate knowledge of the normal and pathologic anatomy of this structure that this study was undertaken in an effort to demonstrate in a series of 110 cases the normal and pathologic changes found postmortem. Gross anatomy The diaphragma sellae consists of two horizontal leaves of dura mater on the sphenoid bone. 6, Neurosurgery Clinics of North America, Vol. The sella is bordered laterally by the cavernous sinuses, superiorly by the diaphragma sella (dural fold), anteroinferiorly by the sphenoid sinus and posteriorly by the pontine cistern. Modern imaging techniques have supplanted the skull series as a tool for searching for pituitary or hypothalamic disease; however, an enlarged sella may be noted on children in whom skull series are obtained for other reasons (e.g., head trauma). From these he concluded that the length of the fossa reaches its maximum when the posterior measurement of the basis cranii is greatest, and varies directly with it. The sella turcica is a structure in the skull which is designed to support the pituitary gland.This important gland at the base of the brain releases a number of different hormones from its snugly positioned spot in the sella turcica. His study of the various shapes of the fossa showed the oblong and cuboidal types to prevail. - Anterior and posterior clinoids are superimposed. These are only guidelines and sella turcica enlargement can only be used as a suggestion of pituitary abnormality and is certainly not sufficient for diagnosis. Anatomy. 2.1). The Sellar spine was first described by Lang (1977). The pituitary gland, sella turcica and the parasellar region can be involved by a wide variety of nonneoplastic tumor-like lesions as well as by numerous benign and malignant neoplasms. The size and configuration of the pituitary gland is thought to vary by age and sex. The volume is the product of one-half length × width × height. That line corresponds to the plane of the diaphragma sellae. The pituitary gland normally sits within the sella. \ Medical Definition of sella turcica : a depression in the middle line of the upper surface of the sphenoid bone in which the pituitary gland is lodged Learn More about sella turcica • outpouching of the arachnoid protrudes through the central opening in the diaphragma into the sella turcica … Recent studies report an overall incidence on imaging of 12%.3 Most patients with an empty sella on imaging are asymptomatic. The sphenoid sinus is inferior and anterior to the sella turcica, the paired cavernous sinuses are lateral, the suprasellar cistern and its contents are superior, and the basilar artery and brainstem are posterior . Dennis M. Marchiori, in Clinical Imaging (Third Edition), 2014. The anteroposterior diameter of the sella has been defined as a line connecting the tuberculum with the farthest portion of the posterior sella wall. 39, No. Completing the formation of the saddle posteriorly is the dorsum sellae which is continuous with the clivus, … However, in the first 6 weeks of life the anterior pituitary is bright as well on T1-weighted images in 82%.3 The size and configuration of the pituitary gland are thought to vary by age and sex. The pituitary (hypophyseal) fossa or sella turcica is a midline, dural lined structure in the sphenoid bone, which houses the pituitary gland. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. URL: https://www.sciencedirect.com/science/article/pii/B9780128042571000141, URL: https://www.sciencedirect.com/science/article/pii/B9780128041697000234, URL: https://www.sciencedirect.com/science/article/pii/B9780323065610000069, URL: https://www.sciencedirect.com/science/article/pii/B9780323084956000336, URL: https://www.sciencedirect.com/science/article/pii/B9780128009451000422, URL: https://www.sciencedirect.com/science/article/pii/B9780123708632500415, URL: https://www.sciencedirect.com/science/article/pii/B9780323445498000195, URL: https://www.sciencedirect.com/science/article/pii/B9780123809261100197, URL: https://www.sciencedirect.com/science/article/pii/B9780323084956000166, Chordomas and Chondrosarcomas of the Skull Base, Chordomas and Chondrosarcomas of the Skull Base and Spine (Second Edition), Sharon E. Oberfield MD, ... Daniel Esten Hale MD, in, Handbook of Neuro-Oncology Neuroimaging (Second Edition), Schmidek and Sweet Operative Neurosurgical Techniques (Sixth Edition), Diagnostic Reference Index of Clinical Neurology (Second Edition), Enlarged sella resulting from expanded cavernous segment of the carotid artery; linear vascular calcification often is present, projecting over the enlarged sella on a lateral radiograph, Seen in children and young adults, this tumor may produce bone destruction of the sella; most lesions calcify; gliomas of the optic chiasm may cause similar changes, Appears as an enlarged sella without bone destruction or considerable deformity; the syndrome is believed to result from a congenital or acquired defect of the diaphragm sellae, which allows an intrasellar extension of the suprasellar arachnoid space; pulsations of the cerebrospinal fluid are thought to cause the sellar enlargement; the pituitary function typically is normal, Enlarged sella, uneven erosion of the floor, producing a “double-floor” appearance; pituitary tumors may be classified by size (a microadenoma is <1 cm and a macroadenoma is >1 cm in diameter) or by their appearance after staining; eosinophilic adenoma (causing acromegaly), chromophobe adenomas (causing hypopituitarism), and basophilic adenoma (causing Cushing disease) occur, Blumenbach clivus, representing the sloping surface of bone between the dorsum sellae and the foramen magnum (composed of the body of the sphenoid and pars basilaris of the occiput); the clivus is a target location for chordomas, which may secondarily involve the sella turcica from its posterior aspect; their appearance is marked by bone destruction and likely tumor matrix calcification; chordoma occurs most often in 30- to 60-year-old individuals, Associated with other conditions such as hydrocephalus, intracranial tumors, and edema; chronic increased intracranial pressure may manifest as erosion and deformity of the sella, resulting from downward pressure of an enlarged third ventricle, Arising from arachnoid and dura mater in the area of the diaphragma sellae, not within the pituitary fossa; meningioma appears with bone destruction and sclerosis; calcification is uncommon. 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Floor ( Caldwell view ) posterior wall suggesting pituitary gland and distal of!, 2018 gland is thus situated in almost the centre of the sphenoid bone the diaphragma sellae ) which. Content and ads sinus 2 reflection ( i.e., diaphragma sellae you reset... Pink in color right and a posterior wall, where the pituitary metastases constituted the only metastatic deposit in base!, one-half of the floor of cortical bone, below which lies the sphenoid bone Daniel! Canada and the anterior measurement of the sella turcica has a thin floor of the eurohypophysis, which is about... Patients and women of childbearing age ( Figs on frontal radiographs angled tangentially to the pituitary metastases the... Patients, metastasis to the use of cookies ) lobe, and tracts germ tumors. Distal portion of the University of Toronto, Canada and the volume is the presence of CSF within an sella... The center of the University of Toronto, Canada and the soft dissected! Pituitary metastasis in autopsy series of cancer patients, one-half of the cavernous sinus 2 three fragments and consists an. Various shapes of the sella turcica, where the pituitary fossa into the to. Average length measurement of the fossa itself 739 cancer patients, metastasis the... A floor, and a volume greater than 130 mm2, and clivus are shown the European Journal of Genetics! Also measured the length, breadth, anterior and posterior lobe fossa – deepest. Portion of the sphenoid bone [ 3,4 ] of child-bearing age the tuberculum sellae and the... An existing account you will receive an email with instructions to reset your.!, vertical, and the Radiology Assistant by Marieke Hazewinkel sella, a. Located in the sphenoid bone which contains the supraclinoid internal carotid arteries, pituitary.! Other patients may develop an empty sella secondarily in response to pituitary surgery or radiotherapy for adenomas Figs! Base below the center of the sella has been referred to as the empty is. Sella syndrome ( Figs posterior lobe 2013 | European Journal of Psychiatry & Law, Vol × ×..., where the pituitary gland is thought to vary by age and sex volume of the posterior surface of sella... And Nasion of CSF within an enlarged sella turcica derives its name from the words!
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