Endoscopic endonasal management of encephaloceles in children: An eight-year experience

Castelnuovo, Paolo; Bignami, Maurizio; Pistochini, Andrea; Battaglia, Paolo; Locatelli, Davide; Dallan, Iacopo

doi:10.1016/j.ijporl.2009.04.023

Cited by 54 publications

(52 citation statements)

References 25 publications

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“…Several surgical approaches have been proposed such as transcranial, facial and endonasal endoscopic surgery. These approaches may be used alone or in combination [3,6,9,11,14,15,16,17]. The transcranial approach has the advantage of reviewing the contents of the hernial sac, easing the removal of the malformed cerebral tissue and achieving satisfactory dural closure.…”

Section: Discussionmentioning

confidence: 99%

“…This is why it is often combined with the facial approach, which has an advantage on bone and cutaneous repairs but is limited in terms of dural closure [6,14,17]. The endoscopic endonasal route alone [11,15,16] or combined [2,17] with the transcranial approach (in large bone defects) was also used for the treatment of sincipital cephaloceles. With the endoscopic approach, a small defect can be closed using a small harvest of the nasal septum [11].…”

Section: Discussionmentioning

confidence: 99%

“…With the endoscopic approach, a small defect can be closed using a small harvest of the nasal septum [11]. The main complication of the endoscopy is CSF leak, which is effectively treated by lumbar puncture [2,11,15]. …”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Frontoethmoidal Cephalocele: Our Experience of Eleven Cases Managed Surgically

Zabsonre¹,

Kabré²,

Haro³

2015

Pediatr Neurosurg

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Introduction: Frontoethmoidal or sincipital cephaloceles are congenital malformations characterized by externalization of the meninges and/or brain tissue through a congenital bone defect between the frontal and ethmoid bones. These sincipital cephaloceles are very infrequent. While in developed countries the measures taken have brought about virtually zero frequency of this pathology, in our work environment these measures are virtually nonexistent, so that frontoethmoidal cephaloceles remain one of our concerns. Aim: To describe the particularity of the management of frontoethmoidal cephaloceles in our country. Methods: This was a retrospective study carried out between January 1, 2007 and June 30, 2013. It concerned all cases of frontoethmoidal cephaloceles managed in the Neurosurgery Department of the University Hospital of Ouagadougou. Results: A total of 11 patients (6 females and 5 males) were attended to in 6.5 years. The age of the patients ranged from 1 day to 12 years, and 8 patients (72.72%) were less than 4 months old; 1 case was diagnosed at antenatal ultrasound. Clinically, all cases consisted of congenital cephalic swelling of gradual increase. A CT scan was performed in all cases and an ultrasound of the associated mass was carried out in 2 cases. Transcranial approach was done for all patients with 3 patients having had an incision of the mass to reduce redundant skin. The immediate postoperative course was favorable in 10 cases; 1 death was observed by cerebrospinal meningitis. We noted 1 case of recurrence. Conclusion: The surgical treatment of frontoethmoidal cephaloceles is complex, sometimes requiring a multidisciplinary team. However, early closing of the malformation before the appearance of important bone deformities can prevent maxillofacial surgery. The results of the surgery are satisfactory as regards the vital prognosis. However, the fear of a more or less long-term occurrence of psychomotor retardation and the complications of early surgery make the recommendation and emphasis of prevention our main concern.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Frontoethmoidal Cephalocele: Our Experience of Eleven Cases Managed Surgically

Zabsonre¹,

Kabré²,

Haro³

2015

Pediatr Neurosurg

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“…Encephaloceles are more frequently observed in girls [20,21]. The continuity with the extracranial space can be associated with an increased risk of tearing of the sac, with consequent cerebrospinal fluid leakage and subsequent increase in the risk infection and meningitis [21].…”

Section: Discussionmentioning

confidence: 99%

Inferior encephalocele: transpalatal repair using paired costal bone grafts with a 14-year follow-up

Hassani

Karimi

Hassani³

2011

Journal of Pediatric Surgery

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“…11,15) Advances in instruments and surgical techniques allow endoscopic surgery for encephalocele, meningocele, and meningo-encephalocele. 2,3,5,6,12,13) The success of endoscopic surgery depends on precise localization of the origin of the CSF fistula on neuroimaging and specific repair based on the diagnosis. However, the exact limitations of endoscopic repair for meningo-encephalocele, meningocele, and encephalocele in the sphenoid sinus remain unclear, especially in terms of the size and the location of the skull base defect.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Management of a Traumatic Meningo-encephalocele Through a Planum Sphenoidale Defect -Case Report-

Komatsu

Ohmura

et al. 2010

Neurol. Med. Chir.(Tokyo)

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A 37-year-old man involved in a motor vehicle accident was admitted to our hospital with disturbed consciousness. Computed tomography (CT) showed an acute, right-sided epidural hematoma and pneumocephalus. Emergency evacuation of the acute epidural hematoma was carried out, and his condition gradually recovered. However, cerebrospinal fluid (CSF) rhinorrhea continued despite conservative treatment. Three-dimensional reconstructed CT revealed a bone defect, which was approximately 20 mm in size, in the planum sphenoidale and tuberculum sellae, and magnetic resonance imaging demonstrated a traumatic meningo-encephalocele through the defect, with CSF collection in the sphenoid sinus. Endoscopic endonasal transsphenoidal surgery was performed. The 9-mm diameter dural defect was clearly visualized in the sphenoid sinus and was reconstructed with a combination of suturing and overlay with abdominal fascia, and absorbable polyglycolic acid felt. The CSF leakage from a traumatic meningo-encephalocele through the planum sphenoidale was successfully repaired by endoscopic endonasal surgery. Thorough preoperative evaluation of the feasibilities of the endoscopic and transcranial approaches should be based on the preoperative identification of the fistula, the bone defect, and vital structures.

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Endoscopic endonasal management of encephaloceles in children: An eight-year experience

Cited by 54 publications

References 25 publications

Frontoethmoidal Cephalocele: Our Experience of Eleven Cases Managed Surgically

Frontoethmoidal Cephalocele: Our Experience of Eleven Cases Managed Surgically

Inferior encephalocele: transpalatal repair using paired costal bone grafts with a 14-year follow-up

Endoscopic Management of a Traumatic Meningo-encephalocele Through a Planum Sphenoidale Defect -Case Report-

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