Low incidence of true Sternberg’s canal defects among lateral sphenoid sinus encephaloceles

Closure of spontaneous cerebrospinal fluid leakage via fistula at the lateral wall of the sphenoid sinus using a bone pile

“…Previously, for small defects, only soft reconstruction was performed with fascia or fat and rigid reconstruction was not recommended. 7 , 8 , 9 However, since spontaneous CSF leakage is related to chronic intracranial hypertension, 2 , 3 , 4 , 5 , 6 a strong reconstruction is preferable. In this case, the fistula was in the form of a narrow canal; therefore, we processed the vomer bone into a pile and inserted it in a pile‐driving manner.…”

“…According to the previous reports, spontaneous CSF leakage in the sphenoid sinus has often been associated with meningoencephaloceles. 3 , 10 , 11 , 12 CT and MRI are commonly used imaging modalities, with a sensitivity of approximately 90%. 9 However, in this case, CT and MRI of the brain did not raise suspicion of spontaneous CSF leakage.…”

“…The increased intracranial pressure leads to the formation of arachnoid pits, which leads to progressive bone destruction of the skull base. 2 , 3 , 4 , 5 , 6 Therefore, skull base reconstruction should be multilayered and as strong as possible.…”

Closure of Spontaneous Cerebrospinal Fluid Leakage via Fistula at the Lateral Wall of the Sphenoid sinus using a Bone Pile

“…Spontaneous cerebrospinal fluid (CSF) leakage occurs because of increased intracranial pressure; however, it has been reported to be caused by residual Sternberg's canal 1 and progressive pneumatization of the lateral fossa of the sphenoid sinus. The increased intracranial pressure leads to the formation of arachnoid pits, which leads to progressive bone destruction of the skull base [2][3][4][5][6] . Therefore, skull base reconstruction should be multilayered and as strong as possible.…”

Modified Transpterygoid Approach to Sphenoid Meningoencephaloceles: A Shorter Run for a Longer Slide

“…11,12 In the past, repairing these lateral sphenoid recess defects had been challenging given their lateral and posterior locations in the skull base, wherein the transpterygoid approach offered an ideal surgical corridor. 11,12 Based on its original description, infraorbital nerve (V2) hypoesthesia, and decreased lacrimation from vidian nerve injury in the postoperative setting were described, which can be debilitating issues for patients. 13 Additionally, based on original technique, vascular ligation through encountering the sphenopalatine artery (SPA) and internal maxillary artery was required in this description.…”