Frontoethmoidal Encephalomeningocele: Surgical Correction by the Chula Technique

Mahatumarat, Charan; Rojvachiranonda, Nond; Taecholarn, Chopoew

doi:10.1097/01.prs.0000040523.57406.94

Cited by 48 publications

(43 citation statements)

References 16 publications

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“…Most authors consider that the best method is a "combined" procedure: bicoronal insicion, nasofrontal bone flap, and facial reconstruction. 2,5,15,18,20 Others used either bicoronal, transfacial approaches, or combined procedures according to the patient malformation pattern. 9 Some claim that fMEC can be corrected only by an extracranial procedure; 11,14,30 this could be more appropriate in some developing countries where neurosurgical expertise is lacking.…”

Section: Surgical Issuesmentioning

confidence: 99%

Frontoethmoidal meningoencephalocele: appraisal of 200 operated cases

Oucheng

Lauwers

Gollogly

et al. 2010

PED

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Object Frontoethmoidal mengingoencephaloceles (fMECs) are frequently observed in Cambodia, especially in poor families. The authors describe issues related to the surgical treatment of fMECs in Cambodia at the end of a humanitarian program that provided surgery free of charge to patients and their families. Methods The authors reviewed 257 cases of fMEC involving patients who presented to their institution, the Children's Surgical Center in Phnom Penh, between 2004 and 2009. They treated 200 of these patients surgically (108 males, 92 females; 89% younger than 18 years) using a “low-cost” management plan with no routine pre- or postoperative investigations. Initially, surgery was performed by visiting foreign surgeons who taught the procedures to resident surgeons. Patients were not charged for consultations or treatment and received at least 1 follow-up examination 6 months postoperatively. Results The nasoethmoidal type was the most frequent fMEC encountered (69%). Many patients had associated ophthalmological issues (46% of cases). Only 1 familial case was detected. Combined neurosurgical and facial procedures were successfully standardized and learned by surgeons initially unfamiliar with fMEC management. A neurosurgical approach avoided the need for a facial incision in 42 cases, improving cosmetic results. The most common postoperative issues were a temporary CSF leak (24 cases [12%]) and/or infection (28 cases [14%]). There were 3 deaths directly related to the operations. Cosmetic results were good in 145 cases, average in 27, poor in 7, and worse than preoperative appearance in 6 patients. Fifteen patients were lost to follow-up. The parents of 87% of the children were rice farmers. Questionnaire results confirmed that fMEC has important social and educational consequences for the affected children and that these consequences can be partially improved by fMEC correction. Conclusions This experience in fMEC management demonstrates that local surgeons can treat these malformations with limited surgical materials and in a nonspecialized infrastructure after principles of treatment have been learned and if they are carefully respected. Surgery for fMEC can thus be more accessible to a larger number of patients in developing countries. Moreover, local treatment facilitates better postoperative and follow-up care.

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Section: Surgical Issuesmentioning

confidence: 99%

Frontoethmoidal meningoencephalocele: appraisal of 200 operated cases

Oucheng

Lauwers

Gollogly

et al. 2010

PED

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“…In the human literature, the most broadly defined locations are occipital, basal, and anterior . In man, the prevalence of these types varies by geography, with anterior encephaloceles predominating in Southeast Asia and posterior encephaloceles predominating in developed countries . Advanced imaging is required to differentiate between the types.…”

Section: Discussionmentioning

confidence: 99%

Surgical correction of a meningoencephalocele in a thoroughbred filly

Buck

Hunt

2019

Veterinary Surgery

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Objective To describe the surgical correction of a closed meningoencephalocele in a thoroughbred filly. Study design Case report. Animal One thoroughbred filly, 1.5 months old at the time of surgery. Methods A meningoencephalocele was identified at birth and diagnosed with radiography and MRI. The abnormal tissue was excised and submitted for histopathology, the dura was closed, and the defect in the skull was corrected with a titanium mesh. Results Histopathology confirmed the presence of neural parenchyma consisting of neurons and glial cells. The filly remained without neurologic deficits 7 months after surgery. Conclusion Surgical correction of a meningoencephalocele was performed and considered successful, with no long‐term neurologic deficits postoperatively. Clinical significance Given the paucity of neural tube defect cases in the equine population, no surgical corrective techniques have been reported in the literature. This Case Report describes the first successful surgical treatment of a meningoencephalocele in a horse.

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“…The mass is amputated, the dural defect closure attempted through extracranial exposure, and reconstruction performed with a tantalum meshreinforced central bandeau reduction, medial canthopexy with wire attachment, and nasal augmentation with a cantilever bone graft. 6 Correction of skeletal and soft-tissue deformities from a frontoethmoidal encephalomeningocele is challenging. The mass effect shifts the medial orbital walls laterally, resulting in telecanthus.…”

Section: Discussionmentioning

confidence: 99%

“…6 In our study, we describe a procedure designed for resection of the deforming mass, repair of the cranial base defect, and complete reconstruction of the midline hard and soft-tissue structures. We report perioperative and follow-up results, Whitaker score for aesthetic outcome, and developmental tests for neurologic outcomes.…”

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confidence: 99%