Age-Related Volume Analysis of the Sella Turcica and Surgical Approach Metrics to the Pituitary Gland from Birth to Adulthood

Abstract

BACKGROUND/AIMS: The pituitary gland is located in the sella turcica (ST). The volume change of the ST with age affects the pituitary gland. The volume of the ST and the distance from the points of surgical intervention to the pituitary gland should be known prior to surgery. Therefore, the aim of this study was to measure the age-related volumetric development of the ST and to determine the distances of the main surgical landmarks to the pituitary gland. MATERIALS AND METHODS: Our study analyzed sagittal radiologic images of 794 individuals, aged 1-70 years. ST volumes and the distances for transsphenoidal, transcranial (TC), and frontoparietal (FP) surgical approaches were measured. ST volume was quantified using the Cavalieri principle on sagittal images, while surgical approach distances were determined using a ruler on the same sagittal radiological images. RESULTS: The mean ST volume in the age range of 1-18 years was 259.32 +/- 38.28 mm3, 262.40 +/- 38.74 mm3 in males and 256 +/- 37.67 mm3 in females. The volume increase in ST was observed at a high rate until adolescence, when bone development was the highest. There was no statistically significant difference in ST volume between genders. The mean lengths of the transsphenoidal, TC, and FP approaches were 81.64 +/- 9.62, 80.01 +/- 14.85 and 92.56 +/- 8.54 mm, respectively. CONCLUSION: Our study demonstrated that the volume of the ST increases continuously from birth to 18 years of age, with a marked acceleration after 14 years. Additionally, we quantified the distances from various surgical intervention points to the pituitary gland, providing essential data for optimizing surgical approaches.