Nasal Glioma and Encephalocele: Diagnosis and Management

Abstract

Nasal glioma and encephalocele are rare, benign, congenital lesions with a potential for intracranial extension. Evaluation should include a complete rhinologic and neurologic examination. Preoperative imaging with a thin-cut axial and coronal computed tomography scan and/or multiplanar magnetic resonance imaging is essential. Surgical intervention should be performed soon after diagnosis to alleviate the increased risk of meningitis. A frontal craniotomy approach is recommended if intracranial extension is identified based on preoperative evaluation, followed by an extracranial resection. If there is no evidence of intracranial extension, a conservative extracranial approach is recommended.

Prenatal detection and postnatal management of an intranasal glioma

“…Congenital nasal masses are estimated to occur in 1 in 20,000 to 1 in 40,000 live births [1]. The main differential diagnosis of congenital nasal masses includes dermoids, hemangioma, glioma, and encephalocele, although in adults, polyps must be considered in intranasal cases [1,2].…”

“…The main differential diagnosis of congenital nasal masses includes dermoids, hemangioma, glioma, and encephalocele, although in adults, polyps must be considered in intranasal cases [1,2]. Encephaloceles and nasal gliomas are the result of abnormal embryonic development [1].…”

“…The main differential diagnosis of congenital nasal masses includes dermoids, hemangioma, glioma, and encephalocele, although in adults, polyps must be considered in intranasal cases [1,2]. Encephaloceles and nasal gliomas are the result of abnormal embryonic development [1]. In encephaloceles, there occurs a protrusion of brain parenchyma and meninges through a bony defect, maintaining a connection with the rest of the brain by a pedicle [3,4].…”

“…It is thought to be derived from either entrapped neuroectodermal tissue during the closure of the covering of the brain or a nasal encephalocele in which the CNS connection has either been absorbed or has become vestigial [2,3,5,6]. Nasal gliomas have thus the potential to extend intracranially by a fibrous stalk [1,[6][7][8].…”

Diagnostic and Therapeutic Sinonasal Endoscopy in Pediatric Patients

“…Nasal glioma (NG), also known as nasal glial heterotopias, brain-like heterotopia, glial hamartoma, heterotopic neuroglial tissue, nasal cerebral heterotopias, cephalic brain-like heterotopias, and nasal heterotopic brain tissue (Rahbar et al, 2003;Pakkasjärvi et al, 2008), is a rare benign developmental abnormality of neurogenic origin. The peak of occurrence is between 5 and 10 years of age, with a male-to-female ratio of 3:2 (Puppala et al, 1990;Vuckovic et al, 2006).…”