Intranasal meningoencephalocoele-a rare childhood condition

Congenital or acquired intranasal meningocoele or meningoencephalocoele is a rare condition ever reported in world literature. We report a case of intranasal meningoencephalocoele in which a 10 month old male child presented with left sided progressive nasal obstruction, nasal mass and reluctant to feed. On examination slight broadening of the bridge of the nose with obliteration of left nasomaxillary fold, mucoid discharge and a pinkish, polypoidal, non tender, non pulsatile mass with prominent blood vessels on the surface occupying almost 3/4(th) of the nasal cavity was observed. On probing it appeared to be attached to roof of left nasal cavity. Computed tomography revealed a hypodense area in the nasal cavity but there was no bony defect in the skull base. Peroperatively on aspiration of nasal cystic mass revealed free flow of clear fluid which was biochemically CSF. A one stage, Lynch Howarth approach, correctional procedure was performed. We present here a discussion of findings and surgical treatment. Early diagnosis and referral are of paramount importance, because failure to identify this leads to fatal outcome if surgery performed.