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Empty sella syndrome, diagnosed as allergic rhinitis.
M Gonianakis1, J Segas, K Kontou-Fili
1Section of Allergy and Immunology, Laikon General Hospital of Athens, Greece.
Summary
A rare case of primary empty sella syndrome presented solely as unilateral cerebrospinal fluid (CSF) rhinorrhea. This diagnosis was confirmed after initial misdiagnosis and unnecessary sinus puncture, highlighting diagnostic challenges.
Area of Science:
- Neurology
- Neurosurgery
- Otorhinolaryngology
Background:
- Primary empty sella syndrome is a condition where the pituitary gland is not fully developed within the sella turcica.
- Cerebrospinal fluid (CSF) rhinorrhea, the leakage of CSF from the nose, is an uncommon symptom.
Observation:
- A middle-aged male presented with intermittent unilateral rhinorrhea for five months.
- Initial diagnosis considered allergic rhinitis, leading to an incorrect maxillary sinus puncture.
- Radiological imaging, including skull X-ray and CT scan, was crucial for accurate diagnosis.
Findings:
- The patient's symptoms were ultimately attributed to primary empty sella syndrome.
- The empty sella was potentially caused by an underlying adenoma or meningocele.
- Unilateral CSF rhinorrhea was the sole presenting manifestation.
Implications:
- This case underscores the importance of comprehensive diagnostic evaluation for persistent rhinorrhea.
- It highlights the rare presentation of empty sella syndrome and the potential for diagnostic errors.
- Accurate imaging is critical to avoid invasive procedures and ensure correct diagnosis of CSF leaks.