Endocrine Abstracts

The empty sella syndrome (ESS) is caused by the herniation of the suprarahnoidian space into the sella turcica, generating the compression of the pituitary gland and, in most cases, a remodelling of the sella. The purpose of this study was to evaluate the etiology, the degree of hormonal deficit and the occurrence rate of the signs and symptoms accompanying ESS.

Material and methods: We performed a descriptive, retrospective study by analysing the medical records of the patients admitted to the Endocrinology Clinic, between 1995 and 2005. We identified 49 patients with ESS (39 women and 10 men) with ages between 18 and 68 years, with a mean age of 49.81±10.14. The following parameters were examined: ESS etiology, clinical symptoms, hormonal values, neurological and ophthalmologic evaluation. The following statistical tests were used: Fisher’s exact test, the Hi² test, the paired t test (student) and the Mann-Whitney U test.

Results: Regarding etiology: 38 patients (77.6%) had primary ESS (pEES) and 11 patients (22.4%) had secondary ESS (sEES). Total hormonal deficit was identified in 3 patients, all with pESS. Gonadal insufficiency was identified in 12 patients (11/1), central hypothyroidism in one patient with sEES and functional hyperprolactinemia in 6 patients (5/1). Diabetes Insipidus was found in 3 patients (2/1). Headaches were present in 43 patients (33/10), psychological disturbances in 20 patients (15/5), visual disturbances in 18 patients (10/8), obesity was present in 29 patients (21/8), and arterial hypertension in 27 patients (21/6).

Conclusions: Primary ESS was more frequent than the secondary form, and was more often accompanied by different degrees of pituitary insufficiency. Headaches, psychological disturbances, hypertension and obesity had high occurrence rates in both categories, while visual disturbances and gonadal insufficiency were more frequent in the patients with secondary ESS. Diabetes insipidus can be (rarely) present in both forms.