Transalar transsphenoidal meningoencephalocele presenting in the form of recurrent meningitis: Report of two cases and discussion of the diagnosis and treatment

Abstract

In the two cases reported here, neurosurgery allowed lasting closure of the defect.

Spontaneous transethmoidal meningoencephalocele presenting in the form of recurrent unilateral nasal discharge: discussion of the diagnosis and endoscopic surgical management

“…The formation of a bone and dural defect could be related to a multiple anatomical factors; the thin nature of the skull base bones, later development of the skull base and the lined by adherent dura mater on the upper surface with fragile mucosa on the lower surface. 1 The management of this rare and little-known pathology must be based on a multidisciplinary cooperation and regarding the literature, the best outcomes and results are obtained by a multidisciplinary team of neurosurgeons and otolaryngologists. 14 The main objective of surgical management is to resect the non-functional brain parenchyma herniated inside the sac and reconstruct the defect of the skull base in order to isolate the cranial fossa from the sinonasal cavity.…”

“…The incidence of congenital skull base meningoencephaloceles is estimated to be 1 in 35 000 births and they are usually asymptomatic. 1 Multiple anatomical types of skull base meningoencephaloceles have been described and those vary depending on the localisation of the lesion from: transphenoidal, spheno-orbital, sphenoethmoidal, transethmoidal and sphenomaxillary. 2 The pathway of encephaloceles in the skull base varies from one anatomical types to another: transsphenoidal encephaloceles passes through the body of the sphenoid.…”

Adult Nasoethmoidal Encephalocele Corrected by Supraorbitary Approach: Case Report and Review

“…can be performed with fat tissue, fibrin sealant, and dural substitute. 9,17 Otherwise, transcranial approaches like the traditional Chula technique are preferred in cases with large or ectopic mass, which need some skin removal or recidivist case with previous scar face, but it leaves an inconvenient scar on the patient's face. 6 Some authors described a modified Chula technique, made with no facial incision, using a bicoronal approach to the hernial sac, with correction of skull defect.…”

“…Many endoscopic and open surgical approach techniques have been described in the literature with good results. [6][7][8][9] The present case report describes a 26-year-old male patient with nasoethmoidal encephalocele corrected with a transcranial supraorbitary approach.…”

Bilateral Temporal Bone Meningocele Presenting With Otogenic Meningitis

“…Although some cases report trauma-related cephaloceles, the vast majority of the cases suggest congenital abnormalities. [4][5][6][7][8][9] Cephaloceles are mostly accidental findings in patients who undergo radiological imaging for a number of conditions. Patients may present with symptoms which vary from headache, neck stiffness, photophobia, fever, hearing loss, rhinorrhea, otorrhea, and middle ear infection.…”