Title Značaj Empty selle u procjeni funkcije hipofize Title (english) The significance of Empty Sella in determination of function of hypophisis Author Fran Stjepan Naranđa Mentor Milan Vrkljan (mentor)Committee member Neven Ljubičić (predsjednik povjerenstva)Committee member Jasenka Markeljević (član povjerenstva)Committee member Milan Vrkljan (član povjerenstva)Granter University of Zagreb Defense date and country 2019-07-12, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Pojam „empty sella syndrome“ (ESS) označava prisutnost povećane Sella turcica koja sadrži preoblikovanu hipofizu pritiskom stanjenu uz stražnji i donji zid selle. Stanje je rezultat proširenja subarahnoidalnog prostora u samu sellu kao rezultat nepotpunog kontinuiteta selarne dijafragme. Postoje dva tipa empty sella sindroma (ESS) s razlikom u reperkusiji na endokrini sustav. Stoga, s obzirom na etiologiju, empty sella sindrom može biti primarni, ako ne postoji patološki proces u samoj selarnoj regiji koji je uzrok oštećenja hipofizne žlijezde, ili sekundarni, ako je nastao posljedično nekom specifičnom patološkom procesu. Primarni empty sella sindrom (PESS) može biti incidentalni nalaz ili može biti registriran pri slikovnim metodama pregleda pacijenata koji se prezentiraju s endokrinim poremećajima, neurološkim simptomima, vizualnim smetnjama itd. Može bit uzrokovan intrakranijalnom hipertenzijom i/ili insuficijencijom selarne dijafragme u pacijenata koji prethodno nisu evidentirali nikakvu patologiju vezanu za hipofizu. sekundarni empty sella sindrom (SESS) je puno učestaliji i povezan s raznim patološkim stanjima i procesima selarne regije. Prisutnost intraselarnih masa mijenja normalnu anatomiju dijafragme, istežući, povećavajući i stanjujući ju te povećava šanse za razvoj arahnoidalnih adhezija koje mogu SVS povući prema selarnoj šupljini. Kirurški zahvati radioterapija, medikamentna terapija, infekcije, post-partum hipofizna nekroza, traume i spontane rezolucije mogu inducirati smanjenje selarne mase i potaknuti nastanak sekundarnog empty sella sindroma povezanog s razvojem ožiljkastog tkiva, koje nakon par mjeseci pomoću retrakcije mogu povlačiti supraselarne strukture uzrokujući vizualne deficite. Stanje se liječi primjereno uzroku samog poremećaja- medikamentnom terapijom endokrinih poremećaja, kirurškom ekscizijom intraselarnih masa i adhezija te smanjenjem intrakranijalnog tlaka.
Abstract (english) The term "empty sella syndrome" (ESS) indicates the presence of an enlarged Sella turcica which contains a remodeled pituitary gland by pressing it against the back and lower wall of the sellar space. The condition is the result of the expansion of the subarachnoid space in the sella as a result of the incomplete continuity of the sellar diaphragm. There are two types of empty sella syndrome (ESS) with a difference in repercussions on the endocrine system. Therefore, with regard to etiology, empty Sella syndrome may be primary, if there is no pathological process in the selar region itself which is the cause of damage to the pituitary gland, or secondary, if it was caused by a specific pathological process. Primary empty sella syndrome (PESS) may be an incidental finding or can be registered with imaging methods of examination of patients presented with endocrine disorders, neurological symptoms, visual disturbances, etc. It may be caused by intracranial hypertension and/or selar diaphragm insufficiency in patients who have not previously documented any pathology of the pituitary gland. Secondary empty sella syndrome (SESS) is much more frequent and associated with various pathological conditions and processes of the selar region. The presence of intrasellar masses changes the normal anatomy of the diaphragm, stretching, enlarging and thining it, and increases the chances of developing arachnoid adhesions that can withdraw the SVS to the sellar cavity. Radiotherapy, surgery, medication therapy, infections, post-partum pituitary necrosis, trauma and spontaneous resolution may induce a reduction in the sellar mass and stimulate the emergence of secondary empty sella syndrome associated with the development of scar tissue tissues, which after a few months of retraction can pull the supraselar structures causing visual deficits. The disease is treated appropriately to the disorder-medical therapy of endocrine disorders, surgical excision of intrasellar masses and adhesions and reduction of intracranial pressure.
Keywords
empty sella sindrom (ESS)
endokrini poremećaji
hipofiza
Keywords (english)
empty sella syndrome (ESS)
endocrine disorders
pituitary gland
Language croatian URN:NBN urn:nbn:hr:105:420376 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2020-01-08 15:07:55
