Surgical Management of Congenital Median Perisellar Transsphenoidal Encephaloceles With an Extracranial Approach

Spacca, Barbara; Amasio, Maria Enrica; Giordano, Flavio; Mussa, Federico; Busca, Gianpaolo; Donati, P; Genitori, Lorenzo

doi:10.1227/01.neu.0000351780.23357.f5

Cited by 25 publications

(25 citation statements)

References 31 publications

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“…When there is sufficient pneumatization of the sphenoid sinus, the lateral craniopharyngeal canal (Sternberg's canal) may act as the site of origin of congenital meningocele or cerebrospinal fluid (CSF) fistula. [242628] The trans-sphenoidal type represent less than 5% of all basal meningo encephaloceles and has an estimated incidence of one in 700000 live birth. [112161819] Abiko, et al .…”

Section: Introductionmentioning

confidence: 99%

Intrasphenoidal Meningo-encephalocele: Report of two rare cases and review of literature

Sanjari¹,

Sa²,

Amiri³

et al. 2013

Surg Neurol Int

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Background:Transsphenoidal encephaloceles represent a rare clinical entity with wide range of symptoms in adult. Such lesions require accurate diagnosis and surgical treatment. The incidence of congenital encephalocele is very low occurring in approximately 1 in 3000-5000 live births. Even though 63 similar cases have been reported in the literature not all of them have been discussed completely. Due to the rare occurrence of these lesions, we will focus on the main clues in the diagnosis and management of such lesions, which are challenging.Case Description:We intend to present our experience with two cases of trans-sphenoidal meningoencephalocels, one located medially and the other herniating through the Sternberg's canal. The younger was 17 and the elder was 47 years old and both of them presented with cerebrospinal fluid (CSF) leakage. Both patients were treated successfully using pure endoscopic endonasal approach.Conclusion:Ideal surgical approach for such patients is still not clear due to lack of adequate experience in the literature, it is suggested that full preoperative imaging studies might lead the surgeons to undertake minimally invasive skull base approaches in similar patients.

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Section: Introductionmentioning

confidence: 99%

Intrasphenoidal Meningo-encephalocele: Report of two rare cases and review of literature

Sanjari¹,

Sa²,

Amiri³

et al. 2013

Surg Neurol Int

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“…The only successful adult case was an 18-year-old boy with panhypopituitarism and visual loss who underwent microscopic transpalatal approach for correction of TTSME. Eight-year follow up revealed improvement in visual and hormonal functions [8].…”

Section: Discussionmentioning

confidence: 94%

“…While intraoperative CSF drainage through a lumbar drain could reduce the size of the sac and minimize the risk of damage to vital structures [4], chance of relapse remains in addition to other complications [8].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic repair of transsellar transsphenoidal meningoencephalocele; case report and review of approaches

Jalessi

Jahanbakhshi

Sharifi

et al. 2015

Interdisciplinary Neurosurgery

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We present an extremely rare case of transsellar transsphenoidal meningoencephalocele in a 36-year-old woman with pituitary dwarfism complaining of nasal obstruction. Imaging studies showed a bony defect in the sellar floor and sphenoid sinus with huge nasopharyngeal mass and 3rd ventricle involvement. Using endoscopic endonasal approach the sac was partially removed and the defect was reconstructed with fat and fascial graft, and buttressed with titanium mesh and septal flap. Visual field improvement was noticed post-operatively and no complication was encountered during follow-up. So, endoscopic endonasal approach with partial resection of the sac is a safe and effective treatment for this disease

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“…Traditionally, they are operatively approached externally via craniotomy routes, and if approached correctly, the extracranial approach is also a safe procedure with subsequent low morbidity [22].…”

Section: Discussionmentioning

confidence: 99%

“…The endoscopic endonasal approach for the treatment of CSF leaks and encephalocele of the anterior skull base, specially in presence of large adhesions to the surrounding tissues, is the preferred method of repair in most of these cases [7][8][9][20][21][22][23][24]. In the presence of adhesions, endoscopic management of skull base defects is an effective method of treating adults [7,21].…”

Section: Discussionmentioning

confidence: 99%

Inferior encephalocele: transpalatal repair using paired costal bone grafts with a 14-year follow-up

Hassani

Karimi

Hassani³

2011

Journal of Pediatric Surgery

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Surgical Management of Congenital Median Perisellar Transsphenoidal Encephaloceles With an Extracranial Approach

Abstract: The surgical treatment of CTE is indicated to stop the progression or improve symptoms related to this disease entity. If approached correctly, the extracranial approach is a safe procedure with subsequent low morbidity.

Cited by 25 publications

References 31 publications

Intrasphenoidal Meningo-encephalocele: Report of two rare cases and review of literature

Intrasphenoidal Meningo-encephalocele: Report of two rare cases and review of literature

Endoscopic repair of transsellar transsphenoidal meningoencephalocele; case report and review of approaches

Inferior encephalocele: transpalatal repair using paired costal bone grafts with a 14-year follow-up

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