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May 1980

CSF Rhinorrhea Associated With the Empty-Sella Syndrome

Author Affiliations

From the Divisions of Otolaryngology (Drs Gray and Leveque), Neurological Surgery (Dr Salcman), and Neuroradiology (Dr Rao), the University of Maryland School of Medicine, Baltimore.

Arch Otolaryngol. 1980;106(5):302-305. doi:10.1001/archotol.1980.00790290054017

• The empty-sella syndrome consists of the abnormal extension into the sella turcica of an arachnoid diverticulum filled with CSF, which displaces and compresses the pituitary gland. Such a diverticulum can erode through the sellar floor and lead to CSF rhinorrhea through the sphenoidal sinus. Empty-sella syndrome should be considered a diagnostic possibility in patients with nontraumatic CSF rhinorrhea. Diagnosis and treatment are best accomplished with a team approach involving the otolaryngologist, neurosurgeon, neuroradiologist, and neuroendocrinologist. Definitive diagnosis requires pneumoencephalography and thin-section polytomography. Attention should be directed to the possibility of a coexisting pituitary adenoma. Treatment can be accomplished by a transseptal, transsphenoidal approach with localization and repair of the leak.

(Arch Otolaryngol 106:302-305, 1980)

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