Intraoperative CSF leaks were significantly more frequent with ESS (54% vs 24%, p < 0.001), and despite sellar floor repair, the rate of postoperative CSF leaks was also increased (6% vs 3%, p = 0.27). Among patients with ESS, the presence of complete ESS predicted a worse long-term outcome (p = 0.04). Long-term remission was achieved in most patients in both groups (5-year cure: 85% vs 92%, p = 0.10). After surgical management, immediate biochemical remission was achieved in 69 patients (88%) with ESS and 75 controls (96%, p = 0.10). Seventy-eight patients with CD and primary ESS were identified and matched with 78 patients with CD without ESS. Cerebrospinal fluid leaks were recorded as a secondary end point. The primary end points were immediate and long-term biochemical outcome. Thirteen of 16 patients (81%) were obese women (mean body mass index 35.9 kg/m2 normal, 2 mm but less than three-quarters of the total sellar depth. Mean CSF pressure was 28.3 cm of water (range, 19-34 cm normal, 0-15 cm). Three patients had lumbar punctures with measurement of CSF pressure during computed tomography cisternograms because of multiple skull base defects. One patient did not have complete imaging of the sella. Fifteen patients with imaging of the sella turcica had empty (10 patients) or partially empty (5 patients) sellas. Five patients had multiple simultaneous encephaloceles. ![]() All 16 patients had associated CSF leaks. Sixteen patients were treated for spontaneous encephaloceles between 19. The objective of this study was to examine the association between spontaneous encephaloceles/CSF leaks and empty sella syndrome because of their similar clinical features and potential common pathophysiology. Empty sella syndrome occurs when intracranial contents herniate through the sellar diaphragm filling the sella turcica with CSF and giving the radiographic appearance of an absent pituitary gland. Spontaneous, idiopathic nasal meningoencephaloceles are herniations of arachnoid/dura and cerebrospinal fluid (CSF) through anatomically fragile sites within the skull base. ![]() Spontaneous nasal cerebrospinal fluid leaks and empty sella syndrome: a clinical association. The diagnosis was probable rupture of an intrasellar epithelial cyst, leading to empty sella syndrome. Hemosiderin-filled phagocytes and acinar structures were also seen. On histologic examination,the cyst wall showed low pseudostratified cuboidal epithelium and occasional squamous metaplasia. Recovery was uneventful, and the patient was given replacement therapy. The sella was empty except for a whitish membrane no pituitary tissue was seen. Transsphenoidal exploration was carried out. Roentgenogram showed a large sella with some destruction of the posterior clinoids. ![]() Luteinizing hormone level was in the low-normal range. Endocrine studies showed hypopituitarism with deficiency of growth hormone and follicle-stimulating hormone, an abnormal response to metyrapone, and deficiency of thyroid function. Raiti, S Albrink, M J Maclaren, N K Chadduck, W M Gabriele, O F Chou, S MĪ 15-year-old boy had growth failure and failure of sexual development. The association of empty sella with polydactyly is not reported yet in the medical literature and is probably coincidental.Įmpty sella syndrome secondary to intrasellar cyst in adolescence. The particularity of reported case consists of association empty sella with GH deficiency and polydactyly. In connection with this particular case, we propose a review of current knowledge in empty sella syndrome. Associated he presented left hand postaxial polydactyly. The cause of short stature was isolated growth hormone (GH) deficiency. We present the case of a male Caucasian child, aged four years and two months, for short stature and diagnosed by imaging procedures as empty sella. Empty sella syndrome is the pathological variant of the imaging-described empty sella. Jurcă, Maria Claudia Bembea, Marius Kozma, Kinga Åžandor, Mircea Ioan Negrean, Rodica Anamaria Dobjanschi, Luciana Cuc, Emilia AlbiniÅ£a PetcheÅŸi, CodruÅ£a Diana Jurcă, Alexandru DanielĮmpty sella means the absence of the pituitary gland on cranial computed tomography or magnetic resonance imaging. Empty sella associated with growth hormone deficiency and polydactyly.
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