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[Meningoencephalocele as rhinosurgical problem]
1Katedra i Klinika Chorób Uszu, Nosa, Gardła i Krtani AM w Gdańsku.
Otolaryngologia Polska = the Polish Otolaryngology
|October 4, 2003
Summary
Cephalocele, a rare cranial lesion, can present as a meningocele or encephalocele. Surgical approaches, including rhinosurgical and combined methods, effectively treated these sinonasal hernias in three patients.
Area of Science:
- Neurosurgery
- Otolaryngology
- Radiology
Background:
- Cephalocele is a rare extracranial herniation of meninges, often congenital or traumatic.
- Nasal and sinonasal cephaloceles involve the anterior cranial fossa, presenting as hernias within the nasal cavity or paranasal sinuses.
Observation:
- Three cases of sinonasal cephalocele are presented: a meningocele in an adult female with rhinorrhea and headache, and two encephaloceles in pediatric patients presenting as nasal tumors or causing meningitis.
- Diagnostic imaging (CT and MRI) was crucial in identifying the location and extent of the cephaloceles within the ethmoid and frontal sinuses.
Findings:
- Successful surgical removal of sinonasal cephalocele was achieved using tailored approaches: rhinosurgical for meningocele, combined intracranial and lateral rhinotomy for encephalocele, and rhinosurgical for frontal encephalocele.
- Defect repair involved free cartilaginous flaps, periosteum flaps, and combined cartilaginous and mucosal flaps, resulting in good long-term outcomes for all patients.
Implications:
- The choice between rhinosurgical and combined surgical access for sinonasal cephalocele depends on specific anatomical and pathological characteristics of the lesion.
- Effective management of these rare lesions requires a multidisciplinary approach, integrating neurosurgical and otolaryngological expertise.