Medical evaluation of empty sella in aircrew: a clinical analysis of 5 cases

Objective To illustrate the areomedical considerations and certification issues for aircrew with empty sella (ES). Methods The medical assessment data of 5 pilots with primary empty sella admitted to our hospital from 2009 to 2015 were retrospectively analyzed and its related literatures were reviewed. Results Of the 5 cases with average age of 42 years, 3 pilots were admitted for headache, 2 for other reasons and they were diagnosed as ES by cranial MRI. All of them had no apparent endocrine abnormality. Two patients presented with visual disorder. Two were permitted to return to flight and the illness showed no progression during the following 5 to 6 years. One was given flying disqualification permanently, the other two were grounded temporarily. Conclusion We suggest that ES pilots with serious symptoms and signs should be disqualified for flying. Those discovered incidentally and have no functional disorders can return to flight. If flying personnel of dual-seat flight with ES recovered without complication or drug adverse reaction after operation or drug therapy, waiver will be considered individually.