Hello sandiz,
Establishing the correct site of CSF rhinorrhea is of prime importance, and identification of an arachnoidal
intrasellar herniation alone is not diagnostic; rather, it is necessary to demonstrate the actual site of
leakage. Iohexol or metrizamide CT cisternography is currently thought to be more sensitive and specific than
isotope scans .CSF rhinorrhea via an empty sella requires surgical intervention. Like other nontraumatic CSF
leakage, this type of rhinorrhea seldom stops spontaneously. The first step in diagnosis is to determine
whether a high-pressure or normal-pressure mechanism underlies the rhinorrhea. When the pressure is elevated
by a tumor, diagnosis and surgical therapy is primarily directed at tumor diagnosis and removal. However, it
is not enough to correct the cause; the leak must be repaired as well. When the leakage is due to
hydrocephalus, shunting procedures may lead to the development of tension pneumocephalus. Transsphenoidal
repair using fat and fascia, followed by a shunting procedure, may serve to avoid this problem. Occasionally,
transcranial exploration is necessary if the site of leakage cannot be identified on preoperative studies.
You should consult an expert neuruphysician and go for the treatment.
Refer
http://www.pituitaryadenomas.com/emptysella.htm for
more details.
Best
