An unusual presentation of empty sella syndrome in oral and maxillofacial surgery: A case report

Abstract

Oral and maxillofacial surgeons frequently encounter various anatomical abnormalities and incidental discoveries while reviewing routine radiographs. These serendipitous findings can ultimately benefit the patient by enhancing our diagnostic practices and facilitating timely treatment. This report aims to spotlight a noteworthy radiological finding known as "Empty Sella Syndrome" (ESS) and present a case report from our department. ESS involves the compression of the pituitary gland into a thin rim due to increased cerebrospinal fluid pressure, resulting in the appearance of an almost empty sella turcica. This condition impacts both the neurological and endocrine systems in individuals of all age groups, exhibiting a preference for females. A young patient reported with Buccal space infection and drainage of pus extra-orally along with decayed teeth. The treatment planned was Incision & Drainage, extraction of non-restorable teeth under General Anesthesia as it was a challenge to make the patient cooperate under local anesthesia due to her social anxiety and comprehension difficulties. Patients with empty sella syndrome who present with hormonal deficiencies and delay in developmental milestones may experience intellectual disabilities, they require multidisciplinary collaboration, long term treatment and observation. A thorough knowledge of human anatomy and interpretation of radiographs as well as investigations is critical in recognizing such rare and unusual conditions.