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Published on: July 5, 2021
An Endoscopic Endonasal Attempt at Pediatric Meningoencephalocele Repair
Jonathan Raskin1,2, Michela Borrelli2,3, Bozena Wrobel4
1Oakland University William Beaumont School of Medicine, Detroit, MI, USA.
Insights
Meningoencephalocele, a skull base defect, can cause nasal issues and meningitis. This case highlights surgical management of a rare Sakoda complex involving meningoencephalocele in an infant.
Area of Science:
- Neurosurgery
- Pediatric Neurology
- Skull Base Surgery
Background:
- Meningoencephalocele involves abnormal protrusion of meninges and brain tissue through skull base defects.
- Potential complications include nasal obstruction, meningitis, and cerebrospinal fluid (CSF) rhinorrhea.
- Surgical options include open craniotomy and endoscopic approaches.
Observation:
- An 18-month-old female presented with a meningoencephalocele.
- The meningoencephalocele was part of the rare Sakoda complex.
- Sakoda complex comprises meningoencephalocele, agenesis of the corpus callosum, and cleft lip/palate.
Findings:
- The patient underwent initial treatment via an endoscopic transsphenoidal approach.
- A subsequent open craniotomy was performed for definitive management.
- This case illustrates a combined surgical strategy for a complex congenital anomaly.
Implications:
- Highlights the challenges in managing rare congenital skull base defects like the Sakoda complex.
- Demonstrates the utility of a combined endoscopic and open surgical approach.
- Contributes to understanding treatment strategies for pediatric meningoencephalocele.
Abstract:
Meningoencephalocele is an abnormal skull base protrusion of fluid, brain tissue, and meninges that can lead to nasal obstruction, meningitis, and Cerebrospinal Fluid (CSF) rhinorrhea. This condition can be managed operatively through an open craniotomy or a less invasive endoscopic approach. Here, we report a case of an 18-month-old female who presented with a meningoencephalocele that was part of the Sakoda complex, a rare neurosurgical phenomenon consisting of meningoencephalocele, agenesis of the corpus callosum, and cleft lip/palate. The patient was initially treated with the endoscopic transsphenoidal approach with subsequent open craniotomy.
