Sella Turcica and Cranial Base Symmetry in Anterior Synostotic Plagiocephaly Patients: A Retrospective Case–Control Study

<b>Background/Objectives</b>: The present case-control study aims to compare the symmetry of the sella turcica and cranial base of nine patients with anterior unicoronal synostotic plagiocephaly (ASP) and nine healthy patients referred to the maxillofacial unit of the Fondazione Policlinico Universitario Agostino Gemelli. The primary aim of this study is to assess changes in the morphology of the sella turcica and skull base in comparison with a healthy control population using both a 2D and 3D analysis of the sella turcica and skull base. <b>Methods</b>: Computed tomography (CT) scans of nine ASP patients from the Fondazione Policlinico Universitario Agostino Gemelli in Rome were retrieved. A quantitative evaluation of the skull base and the sella turcica was performed through the asymmetry index (A.I.), obtained from the comparison of the point-to-point distances ipsilateral and contralateral to the synostosis. A qualitative three-dimensional (3D) evaluation of the asymmetry of the sella turcica was performed by comparing each sella model with its mirrored counterpart; then, the root mean square (RMS) displacement between the original and mirrored 3D models was calculated. <b>Results</b>: The results showed higher A.I. values in the study group, particularly the length of the anterior cranial fossa, with A.I. values of 7.96 (study) vs. 0.02 (control). <b>Conclusions</b>: The higher values of the asymmetry index observed in the study group supported the presence of statistically significant asymmetries in the sella and cranial fossa measurements compared to the control group.