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Updated: Jul 27, 2026
Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
Single-Stage Endoscopic Repair of Pediatric Basal Encephalocele: A Comprehensive Multimedia Case Report
Bastien A Valencia-Sanchez1, Michael Levy2, Vijay A Patel3,4
1School of Medicine and Health Sciences TecSalud, Tecnologico de Monterrey, Monterrey , Mexico.
Insights
This study presents a successful single-stage endoscopic repair for congenital basal encephalocele in a child. The technique effectively reconstructed the skull base defect using a middle turbinate graft, avoiding open surgery.
Area of Science:
- Neurosurgery
- Otolaryngology
- Pediatric Surgery
Background:
- Basal encephaloceles involve cranial and dural defects, leading to brain tissue displacement.
- Congenital basal encephaloceles require surgical intervention to prevent complications like meningitis.
Purpose of the Study:
- To illustrate a novel surgical approach for congenital basal encephalocele.
- To demonstrate the efficacy of a single-stage endoscopic repair in a pediatric patient.
Main Methods:
- A 10-year-old child with basal encephalocele underwent a single-stage endoscopic endonasal repair.
- A free mucosal middle turbinate graft was utilized for cranial base reconstruction.
- Preoperative antibiotics and lumbar puncture were performed to manage potential intracranial infection.
Main Results:
- The endoscopic repair was technically feasible and successful.
- The middle turbinate graft provided effective reconstruction of the skull base defect.
- The procedure avoided traditional open reconstructive techniques and vascularized flaps.
Conclusions:
- Single-stage endoscopic endonasal approach is feasible for pediatric basal encephalocele repair.
- This minimally invasive technique reduces craniofacial and sinonasal morbidity.
- It offers an effective solution for small cranial base defects in children.
Background And Importance:
Basal encephaloceles are the result of a concomitant cranial and dural defect that allows for inferior displacement of cerebral tissue, meninges, and cerebrospinal fluid into the paranasal sinuses and outside the cranial vault. This work illustrates a step-by-step surgical approach of a successful single-stage, endoscopic repair of a congenital basal encephalocele in a 10-year-old child, using a free mucosal middle turbinate graft that provided effective results without utilization of traditional open reconstructive techniques or vascularized flaps.
Clinical Presentation:
A previously healthy 10-year-old male with a history of unilateral clear rhinorrhea was admitted as an inpatient because of an acute episode of nausea, vomiting, and confusion, accompanied by fever, diplopia, and bilateral abducens nerve palsies. Preoperative imaging revealed a 2-cm right-sided intranasal mass accompanied by a subcentimeter skull base defect spanning the lateral lamella. After completing a course of intravenous antibiotic therapy for 1 week after a negative lumbar puncture to ensure clearance of intracranial infection, the decision was made to proceed with definitive endoscopic skull base repair to obviate recurrent bacterial meningitis episodes and potential neurological complications.
Conclusion:
This study demonstrates technical feasibility of a single-stage endoscopic endonasal approach for pediatric basal encephalocele resection and repair which minimizes craniofacial morbidity associated with traditional open approaches and sinonasal morbidity associated with local pedicle-based flaps for small cranial base defects in this unique patient population.
