Duygu DOLEN BURAK, Cafer İkbal GÜLSEVER, Sefa ÖZTÜRK, Yavuz Bahadır TAKTAK, Mehmet BARBUROĞLU, İlyas DOLAŞ, Altay SENCER, Tuğrul Cem ÜNAL
İstanbul Medical Journal - 2026;27(3):189-193
Introduction: Rathke's cleft cysts (RCCs) are benign lesions of the pituitary region. Variations in sphenoid sinus aeration influence sellar anatomy, but their relationship to RCCs is unknown. This study examined whether specific sphenoid sinus pneumatization patterns are associated with RCCs. Methods: A retrospective case-control study was conducted, including 126 subjects: 63 patients with magnetic resonance imaging (MRI)-confirmed RCCs and 63 control individuals matched for age and sex, who had no evidence of sellar or parasellar pathology. Computed tomography and MRIs images were evaluated to categorize sphenoid sinus aeration as conchal, presellar, incomplete sellar, or complete sellar. All imaging assessments were performed independently by two neuroradiologists (Y.B.T. and M.B.), blinded to group allocation. Statistical comparisons were made using the chi-square test. Results: The RCCs and control groups had comparable ages (43.6+/-12.8 vs. 42.9+/-13.4 years, p=0.78) and sex distribution (61.9% vs. 58.7% female, p=0.71). Among patients with RCCs, the incomplete sellar pattern was the most frequent (58.7%), followed by complete sellar (31.7%), presellar (6.3%), and conchal (3.2%) patterns. In contrast, control subjects most commonly demonstrated complete sellar aeration (52.4%). Overall, pneumatization patterns differed significantly between groups ( chi²: 23.42, df: 3, p<0.05). Conclusion: Individuals with RCCs exhibited a higher prevalence of incomplete sellar sphenoid sinus aeration compared with matched controls. This association may reflect underlying developmental or anatomical factors within the sellar-sphenoid region, potentially contributing to the formation of RCCs or to earlier symptom onset. Awareness of this relationship may support more refined radiologic assessment and improve preoperative planning for patients with cystic sellar lesions.
