Single-Stage Extracranial Transnasal Repair of Frontoethmoidal Encephalomeningocele Without Coronal Incision

The authors present a novel single-stage extracranial transnasal approach for repairing frontoethmoidal encephalomeningocele in a 1-year-old girl, eliminating the need for a coronal incision. Through an inverted-Y nasal incision, the procedure encompassed herniated tissue excision, duraplasty, medial orbital osteotomies for medial hypertelorism correction, cranial base reconstruction with hydroxyapatite and poly-L-lactic acid mesh, costochondral graft nasal dorsum reconstruction, and Y-to-V flap closure. Postoperative recovery was uneventful, with follow-up demonstrating improved orbital alignment and favorable aesthetic outcomes. This technique offers a streamlined alternative to traditional coronal-based approaches, particularly suited for resource-limited settings.