Sella Turcica and Nasal Aesthetics: A Lateral Cephalometric Cross- Sectional Study

Abstract Background: The sella turcica is a crucial neurocranial landmark sharing a close embryological origin with the nasomaxillary complex. While its role in craniofacial growth is established, its direct morphometric correlation with external nasal aesthetics remains poorly understood. Objective: To evaluate the correlation between the digital structural dimensions of the sella turcica and the specific linear and angular cephalometric variables determining soft-tissue nasal aesthetics and projection in adult patients. Materials and Methods: This study analyzed 90 pre-treatment lateral cephalometric radiographs of systemically healthy adult patients (45 males, mean age: 20.5 ± 2.8 years; 45 females, mean age: 21.4 ± 2.6 years) presenting with Skeletal Class I malocclusion and a normodivergent growth pattern. Digital tracing and calibration were executed using MicroDicom software. Sella dimensions (length, depth, diameter) and soft-tissue nasal parameters (length, depth, projection angle, bone length, nasolabial angle) were measured. Blinding protocols were strictly implemented. Statistical analyses were performed using Pearson correlation coefficients, with significance set at P < 0.05. Results: A highly significant, positive correlation was identified between soft-tissue nasal length and all sella turcica dimensions across the total sample, presenting with greater statistical strength in females than in males (P < 0.001). Sella depth maintained the strongest overall association with external nasal length (r = 0.695, P < 0.001). Conversely, no statistically significant correlations were found between any of the sella turcica dimensions and nasal projection angle, nasolabial angle, or nasal bone length (P > 0.05). A weak but significant positive correlation was exclusively observed between sella length and nasal depth (r = 0.262, P = 0.013). Conclusion: Internal sella turcica dimensions serve as significant indicators of soft-tissue nasal length, reflecting a synchronized vertical developmental pathway between the cranial base and the midface. In contrast, external features governing sagittal projection, nasal bone length, and the nasolabial angle operate as morphologically and aesthetically independent traits. These findings offer valuable diagnostic insights for orthodontists and orthognathic surgeons during vertical facial treatment planning.