Evaluation of clinical features of empty cella cases in child patients

Empty sella (ES) is an anatomical condition in which the subarachnoid space expands into the intracellular space resulting in filling of the sella Turcica with cerebrospinal fluid (CSF) and flattening of the pituitary gland. In our study, ES cases determined by retrospective screening from our hospital's imaging and reporting system; it is aimed to evaluate ES with its anatomical structure, etiology, classification and clinical features. A total of 56 patients aged between 6 months - 17 years were included. Radiological images of the patients were re-evaluated by a paediatric radiologist. In 16 patients (28.6%), cranial and/or pituitary MR imaging was performed for endocrinological reasons, in 35 patients (62.5%) because of neurological symptoms, and in five patients for other reasons (after leukaemia treatment, orthodontic complaints, trauma) at the time of diagnosis. 37.5% cases had isolated pituitary hormone deficiency (growth hormone deficiency in ten cases, isolated hypothyroidism in one case, hyperprolactinaemia in eight cases, hypogonadism in two cases). 19.6% cases had multiple pituitary hormone deficiency. As the pituitary height decreased, the incidence of multiple pituitary hormone deficiency increased (r=0.654; p=0.001). ES was found incidentally in 38 (68%) of the patients without any endocrinological problem. Seven of them had varying degrees of hypopituitarism (hypothyroidism, hypogonadism, precocious puberty) during follow-up. Isolated or multiple pituitary hormone deficiencies were observed in 20 of the patients with incidental ES cases at the time of diagnosis. In conclusion, all ES cases, including ES cases without any symptoms, should be evaluated endocrinologically at the time of diagnosis. In addition, it is recommended that these cases should be followed up at regular intervals for early diagnosis and treatment of new endocrinological problems that may develop in the future.