Nasal encephaloceles: a review of etiology, pathophysiology, clinical presentations, diagnosis, treatment, and complications

Abstract

Although cases have been recorded since the sixteenth century, there is still a scarcity of knowledge on the exact causes and factors associated with the development of the disease. Many studies have determined these to be caused by a combination of genetic and environmental factors. Most cases are non-life-threatening and the preferred method of treatment is surgical removal after diagnosis is confirmed with computerized tomography or magnetic resonance imaging. Prognosis is generally positive, especially in the subset of patients with frontoethmoidal encephaloceles.

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

“…965 This lesion typically arises in the midline nasal and anterior skull base and causes nasal obstruction. Characteristic signs are pulsation and expansion of the mass with crying or compression of the jugular vein.…”

Nasal Encephalocoele: An Atypical Case

“…Basal encephaloceles are usually occult and can herniate into nasal structures causing obstruction. 5 Differential diagnosis of this could be traumatic encephalocele, ethmoid-frontal sinus mucocele, neurinoma, hemangioma (the diagnosis becomes obvious if there is a clinical or palpable cerebral pulsation) and glioma.Computed tomography (CT) scans with appropriate bony and soft tissue brain windows and threedimensional reconstruction gives the best assessment. Thus, scans are integral to surgical planning.…”

Endoscopic endonasal resection of a nasal meningoencephalocele - Case report

“…It is considered that the most common type of encephaloceles is the congenital type, defined by a combination of genetic and environmental factors 8 . Other types of MEC, due to their etiology, are posttraumatic, iatrogenic and spontaneous.…”

“…Imaging studies like CT and MRI are both important in the diagnosis of this pathology. CT can be used in the preoperative stage in order to review the surgical area, while MRI should be used for evaluation of the contents in the sac and other neural abnormalities [8][9][10][11] . Surgical treatment is the only choice for MEC and, depending on the size and location, it can be done through different approaches, such as lateral rhinotomy, bicoronal flap, or intranasal techniques 8,11 .…”

“…CT can be used in the preoperative stage in order to review the surgical area, while MRI should be used for evaluation of the contents in the sac and other neural abnormalities [8][9][10][11] . Surgical treatment is the only choice for MEC and, depending on the size and location, it can be done through different approaches, such as lateral rhinotomy, bicoronal flap, or intranasal techniques 8,11 . Recent advancement of endoscopic endonasal techniques has made this type of surgery more frequently used, and it has been successful in many cases of nasal MEC 12,13 .…”