Abdul Rashid Bhat*

Professor and Former Head, Department of Neurosurgery and Head Surgical Emer- gency Services, Sher –i- Kashmir institute of Medical Sciences (SKIMS), Srinagar, Kashmir, India

*Corresponding Author: Abdul Rashid Bhat, Professor and Former Head, Depart- ment of Neurosurgery and Head Surgical Emergency Services, Sher –i- Kashmir institute of Medical Sciences (SKIMS), Srinagar, Kashmir, India.

Received: August 18, 2026; Published: September 10, 2026

Abstract

Objective: The importance of quick and direct access to the sella turcica floor in pituitary adenomas for micro/endo-decompression via TNTS route is crucial for good outcome. However there are several types of anatomical variations in the positions of pituitary floor which have not been studied earlier. Establishing an accurate pre-operative anatomical relationship between the various positional types of pituitary (sellar) floors and the fixed pons (brain stem) resting on the clivus in mid-sagittal MR-images shall help better surgical results.

Material and Methods: This retrospective observational study was carried out on cranio-cerebral MR (magnetic resonance) sagittal imaging of 342 cases of operated pituitary adenomas via trans-nasal trans-sphenoidal (TNTS) route from Jan, 2014 to Dec, 2023 (10 years). On T1, T2 weighted mid-sagittal images, identification and measurements of pons, pontine line, mid-point of pons, mid-pontine perpendicular line (MPL) and floor of pituitary fossa (sellar floor) were carried out to assess the high, medium and low variant types of sellar floors. The statistical law of variance was applied wherever necessary.

Results: The analysis of imaging measurements of 342 pituitary tumor patients, operated for the tumor micro-decompression via TNTS route, revealed that 153 (44.73%) patients had high type sellar floor, 115 (33.62%) patients had medium type sellar floor and 74 (21.63%) patients had a low type sellar floor. There were 17 (4.97%) children, 167 (48.83%) male patients and 158 (46.19%) females. The youngest male was 10 years and the oldest 80 years. The youngest female was 12 years and the oldest 72 years.

Conclusion: The precise preoperative anatomical knowledge about the position of pituitary (sellar) floor in relation to the fixed pons in a particular patient, whether high, medium or low type, shall be of significant surgical value during TNTS procedures to access and decompress the pituitary tumors endoscopically or/and microscopically with minimum time and better outcome.

Keywords: Pituitary Fossa Floor; Anatomical Variant types; Pons (Brain Stem); Sagittal-MRI

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Citation

Citation: Abdul Rashid Bhat. “Anatomical Variant Types of Pituitary Fossa (Sella Turcica) Floors in Relation to Pons (Brain Stem) - Observed on Magnetic Resonance Imaging of Pituitary Tumors During TNTS (Trans-Nasal Trans-Sphenoidal) Micro-Decompression". Acta Scientific Neurology 9.9 (2026): 48-55.

Copyright

Copyright: ©2026 Abdul Rashid Bhat. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.