Empty or partially empty sella turcica (PES) is the effect of invagination of the subarachnoid space filled with cerebrospinal fluid through the diaphragm into the sella, causing pressure and flattening of the pituitary gland of different degrees of advancement. This phenomenon may refer to as much as 35% of the population, originally being the effect of a congenital lack of sella’s diaphragm or its weakening caused by changes in intracranial pressure as well as changes in the volume of the pituitary gland, e.g. during pregnancy, and it may be secondarily triggered by diaphragm injury, e.g. as a result of a stroke. The recognised PES risk factors are: female sex, obesity, arterial hypertension. It is known that even in as many as 5-30% of PES patients there may occur disorders within more than one hormonal axis. The PES is most frequently an accidental finding, diagnosed during CNS imaging examinations, in particular the MRI. Although this phenomenon is more and more frequently diagnosed, there are no standards of procedure developed for patients with such a diagnosis. It is not known how often pituitary MRI and hormonal profile assessment should be performed, or whether the image of the pituitary gland changes in the long-term observation. It was not established what, apart from e.g. the degree of pituitary flattening, may cause hormonal disorders which do not occur in all PES patients, as well as whether these disorders are permanent. In view of the severe consequences, such as effects of hypopituitarism and secondary adrenal insufficiency or hyperprolactinemia and the possibility of infertility development in PES patients, when the diagnosis is made more and more frequently, it seems greatly justified to thoroughly examine this subject.
The planned project involves assessment examination of patients (n=43) in which primary PES was diagnosed based on CNS MRI performed in the Institute of Radiology Diagnostics of the Central Clinical Hospital of the Ministry of Interior and Administration (CSK MSWiA) in Warsaw. Clinical, hormonal and imaging assessment will be conducted in the patients. Students taking part in the project will be involved in each stage of its development: patients’ examination, collection of data and their elaboration, learning and conducting of statistical analysis, preparation and writing of scientific publications under the supervision of senior colleagues (e.g. the supervisor of the Club is a statistician). The students will be able to improve their interpersonal and self-presentation skills when working in the team as well as public presentations during the summary seminars and conferences to be organised.
Thus, the aim of the study is to determine the hormonal profile and clinical and imaging characteristics of PES patients with an assessment of the change dynamics within the examined parameters, which may contribute to the development of standards of procedure among this group of patients, as well as an introduction for the students of medicine to the professional and research work through their participation in the project implementation and promotion.
