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One-stage extracranial repair and reconstruction for frontoethmoidal encephalomeningocele: a new simple technique
C Mahatumarat1, C Taecholarn, T Charoonsmith
1Department of Surgery, Faculty of Medicine, Chulalongkorn University and Hospital, Bangkok.
Insights
This study presents a novel craniofacial technique for treating frontoethmoidal encephalomeningocele. The one-stage extracranial repair offers satisfactory results with simultaneous correction of soft tissue and bony deformities.
Area of Science:
- Craniofacial Surgery
- Neurosurgery
- Pediatric Surgery
Background:
- Frontoethmoidal encephalomeningocele is a congenital condition requiring surgical correction.
- Traditional treatments may involve multiple stages and complications.
Purpose of the Study:
- To evaluate a one-stage extracranial craniofacial technique for frontoethmoidal encephalomeningocele repair.
- To assess the efficacy and advantages of this novel surgical approach.
Main Methods:
- A cohort of 45 patients with frontoethmoidal encephalomeningocele underwent a one-stage extracranial repair.
- The procedure involved a bicoronal scalp flap, orbital wall osteotomy, nasal bone removal, dural repair, and rib augmentation rhinoplasty.
Main Results:
- The craniofacial technique yielded very satisfactory outcomes in all patients.
- Simultaneous correction of soft tissue and bony deformities was achieved.
- Secure dural repair with minimal cerebrospinal fluid leakage and no postoperative brain sequelae were observed.
Conclusions:
- The one-stage extracranial repair is a significant advancement in treating frontoethmoidal encephalomeningocele.
- Advantages include a simpler procedure, simultaneous correction, secure dural repair, and reduced hospital stay.
Abstract:
Forty-five patients born with frontoethmoidal encephalomeningoceles were treated using the craniofacial technique of one-stage extracranial repair and reconstruction. The operation begins with a bicoronal scalp flap, involving frontonasosuperomedial orbital wall osteotomy, reduction of the interorbital distance by nasal bone segment removal, hernial sac amputation and dural repair, medial orbital wall mobilization, medial canthopexy, and rib augmentation rhinoplasty. The result was very satisfactory. This new method has undoubtedly contributed in a major way to the improved results in frontoethmoidal encephalomeningocele treatment. We believe that the main advantages of this technique are that it offers a simple procedure for simultaneous correction of both soft tissue and bony deformities. The direct and external access to the neck of the hernial sac renders more secure dural repair with almost negligible cerebrospinal fluid leakage and eventually none of the postoperative brain sequelae. The postoperative course is less eventful and requires a shorter hospital stay than previous procedures.
