Empty sella syndrome: an update.

INTRODUCTION

Empty sella is characterized by a flattened profile of the pituitary gland that represents in most cases only a radiological incidental finding. When endocrine, ophthalmic, and neurological symptoms occur, this condition is described as empty sella syndrome.

MATERIALS AND METHODS

We searched MEDLINE (PubMed database) with the data filter 2024-2009 using the keywords listed above. The articles met the following inclusion criteria: 1) written in English; 2) published between 1 January 2009, and 31 December 2023; 3) original studies and case series on the epidemiology, characteristics, and treatment of empty sella and empty sella syndrome. Exclusion criteria included: articles written in languages other than English and single case report.

RESULTS

The incidence of empty sella is about 12%, when it comes to neuroimaging, while in clinical practice it can reach 35%. Endocrine pituitary disorders, defined as at least one hormone deficit, were reported in 19% to 40% of patients. Magnetic nuclear imaging (MRI) is confirmed to be the gold standard for radiological diagnosis of empty sella. If no alterations are detected it is suggested a careful revaluation at 24-36 months, in relation to the low risk of progression to PES syndrome.

CONCLUSIONS

Empty sella is, in most cases, a radiological finding without clinical manifestations. In people carrying empty sella hormonal pituitary evaluation should be assessed at the moment of the diagnosis, along with a careful imaging using MRI.