The Turkish saddle is part of the sphenoid bone at the base of the skull, a shape that resembles the saddle of Turkish riders. A feature of this bone is the presence of a fossa at its base, in which the pituitary gland is located, an organ that plays a large role in the functionality of the whole organism as a whole.
One of the main diseases associated with this bone is a syndrome called the empty Turkish saddle (PTS), which simply means the prolapse of the suprasellar tank in the bone cavity.
Causes and symptoms of PTS
The causes of this disease have not yet been fully elucidated. So far, it can be said that this disease can be either secondary, for example, after surgical or radiation treatment of a patient or due to the development of a tumor, or primary, if this treatment was not performed before the pathology was detected and no tumors were detected. Symptoms preceding the occurrence of secondary PTS cannot be considered objective, due to their connection with the treatment, therefore, to identify objective causes and symptoms, it is best to consider only the precedents of the primary PTS. Most of the factors below only contribute to the development of the disease, but cannot cause it on their own.
- Increased intracranial pressure
- Female physiological factors (childbirth, pregnancy, menopause)
- Arachnoid cysts
- Increased pressure directly in the ventricles of the brain
- Autoimmune diseases
- Taking oral contraceptives
Symptoms of the disease
An empty Turkish saddle is most often found in women (80% of cases), over 40 years old. Moreover, approximately 75% of all patients are prone to obesity.
The disease itself is most often asymptomatic and is detected accidentally during radiography of the skull. One of the symptoms that occur in 70% of cases is a headache, because of which most patients do an x-ray. In addition, patients with PTS are often prone to sudden emotional mood swings and personality disorders.
Endocrine symptoms can also help diagnose the disease. These symptoms are characterized by impaired pituitary function of varying severity. Also, with PTS, there are quite often vision problems, which is associated with the location of the visual crosshair of the nerves in the area of the sphenoid bone.
Diagnosis of the disease
The most effective method for diagnosing this disease today is MRI, which is able to visualize in detail the entire internal part of the skeleton of the skull. MRI scans in any plane 1 mm in size.
In addition to MRI, an X-ray examination is also possible, which, of course, cannot give the most accurate results, but is widespread everywhere.
Laboratory diagnosis of this disease is also possible, which consists of determining the amount of tropic pituitary hormones in the blood. This method is not particularly accurate, therefore, it can be used exclusively for auxiliary purposes.
Disease treatment
In the case when the patient has a primary empty Turkish saddle, treatment is not required, only observation by a specialist is sufficient. But, in some cases, there is a need for corrective hormonal therapy. In secondary syndrome, hormone therapy is almost always necessary for the patient to recover normally.
Complications that may require surgical intervention in the treatment of the disease are quite few and they are extremely rare. Thinning of the wall of the Turkish saddle refers to this complication so that cerebrospinal fluid is able to independently flow out of the patient’s nose, as well as the sagging of the intersection of the optic nerves in the openings of the diaphragm of the saddle, accompanied by compression of these nerves and impaired vision function.