Empty Sella Syndrome (ESS) is a disorder involving a bony structure at the base of the brain called the sella turcica.  This structure is responsible for protecting the pituitary gland. The sella is the space around the pituitary gland and when healthy, appears round in nature.  When the sella in unhealthy the pituitary begins to flatten and its shape becomes “crescent” or “banana” shaped. An unhealthy pituitary gland may cause hormonal issues, headaches, swelling of the optic discs, visual impairments and, more rarely, leakage of csf fluid primarily from the nasal cavity.