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Obstructing encephaloceles presenting as chronic rhinosinusitis: lessons learned from a case series
James J Jaber1, Nicolaus Hawbaker, James A Stankiewicz
1Department of Otolaryngology-Head and Neck Surgery, Loyola University Medical Center, 2160 S First Ave, Maguire Building, Maywood, IL 60153, USA.
The Annals of Otology, Rhinology, and Laryngology
|August 24, 2011
Summary
Sinus surgery can reveal sinus encephaloceles, a rare cause of isolated sinus opacification. Early diagnosis and surgical intervention, including cerebrospinal fluid (CSF) leak repair, are crucial for effective management.
Area of Science:
- Otolaryngology
- Neurosurgery
- Radiology
Background:
- Chronic rhinosinusitis can present with isolated sinus opacification.
- Encephaloceles are rare herniations of brain tissue through skull defects.
Observation:
- Two patients with presumed chronic rhinosinusitis were found to have sinus encephaloceles during image-guided sinus surgery.
- The encephaloceles were located in the ethmoid and sphenoid sinuses.
Findings:
- Management strategies included a two-stage approach (CSF leak repair then encephalocele resection) and a one-stage approach (encephalocele resection and CSF leak repair with a septal graft).
- Both patients were successfully treated with surgical intervention.
Implications:
- Sinus surgeons should consider encephalocele in cases of isolated, medically refractory sinus opacification.
- Accurate diagnosis and surgical planning are essential for managing sinus encephaloceles.
- This condition highlights the importance of multidisciplinary collaboration between otolaryngologists and neurosurgeons.
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