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Coned lateral radiographs of sella turcica were studied in 65 patients with advanced chronic obstructive pulmonary disease (COPD) with associated hypercapnia and hypoxemia. Abnormal changes in sella were seen in 27 patients. Two out of 25 age-matched controls showed corresponding changes. Difference between the two groups was statistically significant (P<0.01) A close correlation was observed between the presence of abnormal sellar changes and the arterial Pco2 levels. Age, sex, smoking history and duration of symptomatology did not have any effect on the occurrence of these abnormal sellar changes. The above changes are probably secondary to chronic raised intracranial tension caused by hypercapnia.