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Published on: November 5, 2019
[Iatrogenic nasal meningocele: a cause of recurrent meningitis]
Tolga Kandoğan1, Uğur Cerçi, Levent Aydar
1Department of Otolaryngology, Izmir Training and Research Hospital, Izmir, Turkey. tolga.kandogan@veezy.com
Abstract:
We present a 35-year-old male patient with an eight-year history of endoscopic nasal polypectomy followed by five episodes of meningitis (4 episodes in the past 3 years). His major complaints were right-sided nasal obstruction, frequent watery nasal discharge, headache, and fever. Physical examination revealed a mass in the right nasal cavity. Computed tomography and magnetic resonance imaging demonstrated a defect in the cribriform plate and an ethmoidal meningocele. The patient was referred to the neurosurgery department for surgical reparation.
Insights
A patient with recurrent meningitis experienced nasal obstruction due to a cribriform plate defect and ethmoidal meningocele. Surgical repair was recommended to address this rare condition and prevent further infections.
Area of Science:
- Neurosurgery
- Otolaryngology
- Neurology
Background:
- Recurrent meningitis poses significant health risks.
- Endoscopic nasal polypectomy is a common procedure for nasal issues.
- Cribriform plate defects can lead to cerebrospinal fluid leaks and infections.
Observation:
- A 35-year-old male presented with chronic nasal obstruction, headache, and recurrent meningitis.
- Physical examination revealed a nasal mass.
- Imaging showed a cribriform plate defect and ethmoidal meningocele.
Findings:
- The patient had a history of multiple meningitis episodes following nasal surgery.
- Diagnostic imaging confirmed a bony defect at the cribriform plate.
- An ethmoidal meningocele, a protrusion of the meninges, was identified.
Implications:
- Early diagnosis and surgical intervention are crucial for managing cerebrospinal fluid leaks.
- Addressing the anatomical defect can prevent recurrent meningitis.
- This case highlights the importance of considering sinonasal pathology in patients with recurrent meningitis.
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