The Pituitary Fossa in Childhood with Particular Reference to Hypopituitarism

Abstract

The literature on measurement of the pituitary fossa has been reviewed and a method described for measuring its lateral area. The end-points for measurement have been confirmed by post-mortem injections. Calculations suggested that the radiographic enlargement can be ignored. In the first few years of life, radiographs of the skull did not show the true pituitary fossa since it was lined by cartilage. However, post-mortem measurements suggested that this did not introduce significant error. Measurement of the sellar area in 100 normal children gave findings in agreement with the figures for the normal range. Measurements of the sellar area were made in hypopituitarism and a number of other conditions. In clinically unequivocal cases of hypopituitarism the area of the sella was often small, unless the condition was due to a craniopharyngioma or late in onset. In less certain cases of hypopituitarism the decrease in size was insufficient to give substantial help in making a diagnosis. The impression gained from this investigation was that visual assessment of the sellar size was reasonably accurate in most cases.