Three-dimensional analysis of sella turcica morphology and dimensions in non-syndromic cleft lip and palate patients: A systematic review and meta-analysis

IF 1.8 Q2 DENTISTRY, ORAL SURGERY & MEDICINE International Orthodontics Pub Date : 2024-11-07 DOI:10.1016/j.ortho.2024.100939

Madhanraj Selvaraj , Karthik Sennimalai , Hamza Parvez Siddiqui , Riya Marie Johnson

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Abstract

Introduction

The dimensions and morphology of sella turcica (ST) are often altered in individuals with craniofacial anomalies, including those with cleft lip and palate (CLP). Therefore, the review aimed to identify the current evidence on the 3D morphological characteristics of the ST in patients with CLP.

Methods

A systematic literature search was conducted using different databases without language or publication date restrictions. Studies were included comparing non-syndromic CLP patients to non-cleft controls using 3D imaging techniques for ST assessment. Critical appraisal of included studies was evaluated using the JBI case-control checklist and Anatomical Quality Assurance (AQUA) checklist. A random-effects meta-analysis was used for quantitative synthesis.

Results

Out of 1187 identified articles, six studies met the inclusion criteria. Four studies were rated moderate quality, while two were considered low quality. Most studies reported larger overall ST dimensions in non-cleft controls, with significant differences in ST depth and diameter. The meta-analysis revealed reduced ST depth (MD = −0.95; 95% CI: −1.73, −0.17; P = 0.02) and diameter (MD = −1.00; 95% CI: −1.88, −0.11; P = 0.03) in CLP patients, while no significant difference was observed in ST length. CLP patients exhibited more irregular ST morphologies, such as flattening and irregular posterior walls.

Conclusions

The review highlights an association between CLP and alterations in ST morphology and dimensions. However, variability in methodologies and the lack of standardized protocols across studies limit the generalizability of these findings. Future research should focus on standardized protocols and larger, more diverse samples to enhance the understanding of ST variations in CLP.

Registration

Registered with the International Prospective Register of Systematic Reviews (PROSPERO-CRD42024505594).

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非综合征唇腭裂患者耳廓形态和尺寸的三维分析：系统回顾和荟萃分析。

简介：颅面畸形患者，包括唇腭裂（CLP）患者的耳廓（ST）尺寸和形态通常会发生改变。因此，本综述旨在确定目前有关 CLP 患者耳廓三维形态特征的证据：方法：使用不同的数据库进行系统性文献检索，无语言或出版日期限制。纳入的研究比较了使用三维成像技术评估 ST 的非综合征 CLP 患者和非左侧对照组。采用 JBI 病例对照核对表和解剖学质量保证（AQUA）核对表对纳入研究进行严格评估。采用随机效应荟萃分析进行定量综合：在 1187 篇鉴定文章中，有 6 项研究符合纳入标准。其中四项研究被评为中等质量，两项被评为低质量。大多数研究报告称，非左侧对照组的 ST 整体尺寸较大，ST 深度和直径差异显著。荟萃分析显示，CLP 患者的 ST 深度（MD=-0.95；95% CI：-1.73, -0.17；P=0.02）和直径（MD=-1.00；95% CI：-1.88, -0.11；P=0.03）减小，而 ST 长度无明显差异。CLP患者的ST形态更不规则，如扁平和后壁不规则：综述强调了CLP与ST形态和尺寸改变之间的关联。然而，研究方法的差异和缺乏标准化方案限制了这些发现的普遍性。未来的研究应侧重于标准化方案和更大规模、更多样化的样本，以加深对CLP中ST变化的理解：已在国际系统综述前瞻性注册中心注册（PROSPERO-CRD42024505594）。

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来源期刊

International Orthodontics DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

2.50

自引率

13.30%

发文量

审稿时长

26 days

期刊介绍： Une revue de référence dans le domaine de orthodontie et des disciplines frontières Your reference in dentofacial orthopedics International Orthodontics adresse aux orthodontistes, aux dentistes, aux stomatologistes, aux chirurgiens maxillo-faciaux et aux plasticiens de la face, ainsi quà leurs assistant(e)s. International Orthodontics is addressed to orthodontists, dentists, stomatologists, maxillofacial surgeons and facial plastic surgeons, as well as their assistants.