The Empty Sella Syndrome

Abstract

p ITUITARY tumors often encroach upon and compress the nearby optic nerves and chiasm causing a variety of visual deficits. Chamlin, et aL, 1 reported visual field defects in 86%, optic atrophy in 50%, and impaired visual acuity in 32% of these patients with neoplasms of the pituitary. Since these patients may become totally blind if not treated, the primary objective of treatment is to relieve the pressure on the visual pathways by operative decompression, irradiation, separately or in combination. The success of treatment is measured by the degree of improvement in visual function that can be objectively determined and recorded. Deterioration in visual function after treatment is usually assumed to indicate recurrence of tumor. However, on rare occasions, no tumor is found when the enlarged sella is explored surgically. This condition has been called the empty sella syndrome, ''~ and is a rare complication. We are reporting three cases of this syndrome encountered at the University of California San Francisco Medical Center.