An Otolaryngologic Aspect of Frontal Meningocele: Report of Cases

Application of the Skull Base Technique to the Repair of Transsphenoidal Meningoencephaloceles

“…Moreover, it sometimes involves vital structures (hypo thalamic-pituitary system or major vessels) [8][9][10], The surgical indication in this type of anterior meningoen cephalocele remains controversial because of the high mortality rate, especially in newborns. However, if a respiratory disturbance or a recurrent meningitis is present, surgical treatment is recommended even in very young patients [7,11,12] Of 31 reported cases with transsphenoidal meningoen cephalocele, 20 patients were surgically treated using the transcranial approach (n = 12), the transpalatal approach (n = 3) [13][14][15], the transsphenoidal approach (n = 4) [16][17][18], or the combined transcranial-transsphenoidal ap proach (n = 1 ) [ 19], However, the postoperative outcomes were not satisfactory: of the patients who underwent the transcranial approach, 3 died from hypothalamic dys function [7,20,21 ] and 2 from diabetes insipidus [22,23], The transcranial approach is less risky in terms of infec tious complications [24], but it might compromise the hypothalamic-pituitary function, especially in patients with a large meningoencephalocele. On the other hand, all patients who underwent the transpalatal or the transsphe noidal approach had a good outcome, although these approaches have a higher risk of infectious complications due to insufficient reconstruction [14,21].…”

Transethmoidal intranasal meningoencephalocele in an adult with recurrent meningitis

“…10,11 Meningoencephaloceles may occur as an isolated malformation, however, complicated anomalies are also occur in the face, skull and brain. [12][13][14] The classification of meningoencephalocele is based on the location of the defect in the cranial bones. 9,10 Suwanwela et al classified anterior basal meningoencephalocele into four subgroups: transethmoidal, spheno-ethmoidal, transsphenoidal and frontosphenoidal or sphenoorbital.…”