INTRODUCTION: The dimensions and morphology of sella turcica (ST) are often altered in individuals with craniofacial anomalies, including those with cleft lip and palate (CLP). Therefore, the review aimed to identify the current evidence on the 3D morphological characteristics of the ST in patients with CLP. METHODS: A systematic literature search was conducted using different databases without language or publication date restrictions. Studies were included comparing non-syndromic CLP patients to non-cleft controls using 3D imaging techniques for ST assessment. Critical appraisal of included studies was evaluated using the JBI case-control checklist and Anatomical Quality Assurance (AQUA) checklist. A random-effects meta-analysis was used for quantitative synthesis. RESULTS: Out of 1187 identified articles, six studies met the inclusion criteria. Four studies were rated moderate quality, while two were considered low quality. Most studies reported larger overall ST dimensions in non-cleft controls, with significant differences in ST depth and diameter. The meta-analysis revealed reduced ST depth (MD=-0.95
95% CI: -1.73, -0.17
P=0.02) and diameter (MD=-1.00
95% CI: -1.88, -0.11
P=0.03) in CLP patients, while no significant difference was observed in ST length. CLP patients exhibited more irregular ST morphologies, such as flattening and irregular posterior walls. CONCLUSIONS: The review highlights an association between CLP and alterations in ST morphology and dimensions. However, variability in methodologies and the lack of standardized protocols across studies limit the generalizability of these findings. Future research should focus on standardized protocols and larger, more diverse samples to enhance the understanding of ST variations in CLP. REGISTRATION: Registered with the International Prospective Register of Systematic Reviews (PROSPERO-CRD42024505594).