Transsphenoidal encephaloceles

Transsphenoidal encephaloceles are rare congenital anomalies that may be immediately apparent in infants that present with multiple cranial midline defects. They should also be suspected in patients presenting with cerebrospinal fluid rhinorrhea, an epipharyngeal soft tissue mass, a visual defect, or an endocrinologic disturbance, especially when associated with midfacial and optic nerve anomalies. Plain x-ray films of the skull may show absence of the sellar floor and a soft tissue mass; the diagnosis is confirmed by computed tomography scanning. Surgical therapy may be indicated for persistent cerebrospinal fluid rhinorrhea, symptomatic epipharyngeal respiratory distress, or progression of neurological deficits. Two cases of transsphenoidal encephalocele are reported.