Partially empty sella?

Empty sella is a very common phenomenon in clinical practice. In normal people, the pituitary gland is located in the sella and covered by the septum sellae. Therefore, the sella is usually filled with the pituitary gland. However, in some people, the pituitary tissue in the sella cavity is reduced and occupied by vesicles. This situation is generally called an empty sella. If it is only a mild symptom, no special treatment is required. Just pay more attention to observation.

Causes of Empty Sella

One is that the central hole is congenitally large, and under the pressure of cerebrospinal fluid, the subarachnoid herniation into the sella turcica gradually expands into a cystic shape, squeezing the pituitary tissue to shrink and occupy the sella turcica;

The second is that some physiological or pathological endocrine changes cause the pituitary tissue to swell and enlarge temporarily, and the holes in the sellar diaphragm also enlarge. Afterwards, the pituitary returns to its normal size, which also causes an empty sella.

Thirdly, local infection and trauma in the sella turcica area may cause arachnoid adhesion, which leads to increased cerebrospinal fluid pressure and causes the arachnoid membrane to herniate into the sella turcica. Finally, the sella turcica may be empty after surgical removal of the pituitary tumor or radiotherapy, so the arachnoid membrane herniates into the sella turcica and causes empty sella syndrome.

Clinical manifestations and treatment

Headache, some symptoms of endocrine disorders, and visual field defects. Imaging examination shows enlarged sella turcica, and pneumoencephalography can confirm the diagnosis. Can be treated surgically

Empty sella is a series of clinical manifestations caused by a defect in the sellar septum or pituitary atrophy, in which the subarachnoid space protrudes into the sella turcica under the impact of cerebrospinal fluid pressure, resulting in enlargement of the sella turcica and compression of the pituitary gland.

It is generally believed that if the symptoms are mild, no special treatment is required. However, if the following symptoms occur: persistent headache, progressive visual acuity loss or visual field loss, cerebrospinal fluid rhinorrhea, or obvious endocrine dysfunction, surgical treatment may be an option.

Some patients with empty sella turcica are congenital and generally do not require treatment. However, once cerebrospinal fluid rhinorrhea occurs, you should seek medical attention promptly and then recover through surgical treatment. Some patients may also experience headaches, double vision, visual field loss and even endocrine disorders. Pneumoencephalography is needed to determine whether surgery is necessary.

Empty sella turcica generally presents with clinical manifestations such as migraine, decreased vision, visual field loss, and hyperprolactinemia. However, once cerebrospinal fluid rhinorrhea is discovered, surgery should be performed as soon as possible. In recent years, endoscopic nasal surgery has been recommended, and endoscopic transsphenoidal sella turcica filling has become one of the safe and effective methods for treating empty sella syndrome.

Patients with this disease should monitor their health in a timely manner and undergo regular check-ups to ensure there are no complications. If the patient who needs surgery needs to rest, he should rest in a place with low noise frequency. Have good eating habits and sleep. Generally speaking, patients who undergo surgery will experience little postoperative complications. Some cases may require repeated surgeries to recover.