Empty sella syndrome occurs in the bones (sella turcica) around the pituitary gland when the pituitary gland shrinks or become flattened.

The pituitary gland is a small gland located at the base of the brain. It makes several hormones that control the other glands in the body, including the thyroid, adrenal glands, ovaries, and testicles.

The sella turcica is the bony area surrounding the pituitary gland. When the pituitary gland shrinks or becomes flattened, it cannot be seen on CT or MRI scans. This is referred to as empty sella syndrome.

Primary empty sella syndrome occurs when a small defect above the pituitary gland increases pressure in area.

Secondary empty sella syndrome occurs when the sella is empty because the pituitary gland has shrunk following an injury, surgery, or radiation therapy.

Symptoms of primary empty sella syndrome include:

• Occasional symptoms resulting from high prolactin levels
• Irregular or absent menstruation
• Low libido (sexual desire)
• Impotence (erectile dysfunction)

Often, there are no symptoms or loss of pituitary function.

Patients with secondary empty sella syndrome may have symptoms caused by partial or complete loss of pituitary gland function. For more information, see the article on hypopituitarism.

Empty sella syndrome may be associated with abnormal pituitary function in children, most commonly low levels of growth hormone. However, levels of other pituitary hormones may also be low.

Primary empty sella syndrome is most often discovered during radiological imaging of the brain. Pituitary function is usually normal, and patients do not have any symptoms. The hormone prolactin is a little high in 10-15% of patients, and may interfere with normal function of the testicles or ovaries.

Tests of pituitary gland function may be done to make sure that the gland is working normally. See: Hypopituitarism.