Middle fossa extradural repair of sphenoidal encephaloceles

Sphenoidal encephaloceles are uncommon but potentially dangerous pathological conditions that present with CSF rhinorrhea. Careful radiological evaluation and localisation of the sphenoid defect are critical in defining the surgical approach. We used the middle fossa extradural approach in two patients with sphenoidal encephaloceles in whom previous endoscopic transnasal repairs had failed.