Surgical management and reconstruction of sincipital encephalocele presenting in adulthood
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Sincipital encephaloceles presenting in adulthood are misdiagnosed until they present with persistent cerebrospinal fluid (CSF) rhinorrhea or, in extreme cases, meningeal infection. The basic approach to their repair is a frontal craniotomy and bandeau-type removal of the orbital framework, and reconstruction using dural patch for watertight dural closure, split calvarial bone graft fixation for rigid repair of the bony framework, and a vascularized pericranial flap to provide the soft tissue interposition. We emphasize the pitfall of biopsy when encephalocele is included in the differential diagnosis of a nasal mass and include a step-by-step operative technique that ensures safe and effective reconstruction of the skull base defect.
KeywordsNasoethmoidal encephalocele Sincipital Craniofacial Vascularized pericranial flaps Reconstruction skull base