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Updated: Apr 26, 2026
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Endoscopic transpterygoid approach and skull base repair after sphenoid meningoencephalocele resection. Our
Àngels Martínez Arias1, Manuel Bernal-Sprekelsen2, Elena Rioja3
1Servicio de Otorrinolaringología, Hospital Universitario Parc Taulí, Sabadell, Barcelona, España.
Introduction And Objectives:
Cerebrospinal fluid leaks associated to meningoencephaloceles of the sphenoid lateral recess are rare entities. A congenital bony defect at this level results in the persistence of Sternberg's canal, or a lateral craniopharyngeal canal, which is supposed to be the origin of these lesions. Our objective was to show that the endoscopic transpterygoid approach is an effective technique for their treatment.
Methods:
We present a series of 5 cases of meningoencephaloceles of the sphenoid lateral recess treated with endoscopic sinus surgery (4 women and one man; mean age=59, range 37-72 years). Cerebrospinal fluid rhinorrhoea was present in all of them and they all underwent a transpterygoid approach with reconstruction of the skull base. We describe the surgical technique and review the literature.
Results:
No complications were observed during surgery or the postoperative period. After a mean follow-up of 81 months, only one recurrence was seen.
Conclusions:
The transpterygoid approach has proven to be effective for the treatment of meningoencephaloceles of the sphenoid lateral recess. Providing wide access to identify the defect, followed by meningoencephalocele ablation, is the key for successful surgery.
