Vacuolated saddle, also known as vacuolated saddle syndrome, generally does not require special treatment if the patient is asymptomatic, but must be closely followed up, and it is recommended to do CT, MRI scan and visual field examination once a year in order to detect the lesion early so that treatment measures can be taken. Those with symptoms can be treated symptomatically with medication, and those with severe symptoms can be treated surgically. 1, drug treatment 1, mannitol: mannitol can improve the plasma osmolarity, so that tissue dehydration, can reduce intracranial pressure and intraocular pressure, is the treatment of vacuolation butterfly saddle syndrome intracranial pressure increased commonly used drugs; 2, glucocorticoids: can correct the endocrine dysfunction caused by vacuolation butterfly saddle syndrome by replacing pituitary hormone, commonly used drugs are prednisone, methylprednisolone, etc.; 3, bromocriptine: can act on the adenopituitary gland It can inhibit the secretion of prolactin and correct the hyperprolactinemia caused by vacuolant saddle syndrome. Patients with vacuolant saddle syndrome with hyperprolactinemia should undergo X-ray, CT or MRI examination of the saddle before treatment to confirm the presence of pituitary tumor. Second, surgery is needed if there is intractable headache, progressive vision loss, visual field loss, hypopituitarism and hyperprolactinemia causing amenorrhea, overflow of milk, or cerebrospinal fluid nasal leakage. The surgical method can be chosen depending on the cause and condition. For severe vision loss, adhesiolysis is feasible; for severe cerebrospinal fluid rhinorrhea, saddle base reconstruction can be performed; for severe benign cranial hypertension, cerebrospinal fluid drainage is feasible; for non-tumor cysts, drainage and partial excision of the cyst envelope are feasible. In addition, trans-parietal sinus approach can be used to fill the surgery, which can reduce the recurrence rate after surgery.