Abstract
Purpose
To retrospectively analyse surgical management of clinico-radiologically proven nasal meningoencephalocele amongst children and results of repair with single-layer septo-mucosal flap at a tertiary skull base surgery centre in north India.
Methods
Fifteen children with clinic-radiological nasal meningoencephaloceles with or without CSF rhinorrhoea were included. Radiological scans included CT scans and MRI scans for all cases to delineate soft tissue and bony architecture. All children underwent endoscopic excision of encephaloceles and repair of the skull base defect.
Results
The authors were successful in fourteen cases. Successful cases included 4 children less than 6 months of age who underwent single-layer rotated septo-mucosal flaps, thereby avoiding donor site morbidity.
Conclusion
As endoscopic excision of nasal encephalocele is an established management approach, the authors take the concept of minimally invasive surgery a step further by successfully managing these lesions with single-layer repair. Vascularized septo-mucosal flap seems to be the only determining factor for a successful repair for congenital meningoencephalocele. However, a prospective study comprising a larger subset of patients would substantiate the assumption.
Similar content being viewed by others
References
Jabre A, Tabaddor R, Samaraweera R (2000) Transsphenoidal meningoencephalocele in adults. Surg Neurol 54:183–188
Elluru RG, Wootten CT (2010) Congenital malformations of the nose. In: Cummings otolaryngology – Head & Neck Surgery, 5th edn. Mosby, Philadelphia, p 2687
Gassab E, Krifa N, Kedous S, Zrig A, Hattab N, Harrathi K, Koubaa J, Gassab A (2013) Endoscopic endonasal management of congenital intranasal meningocele in a 2-month-old infant. Eur Ann Otorhinolaryngol Head Neck Dis 130:345–347
Woodworth B, Schlosser RJ (2005) Endoscopic repair of a congenital intranasal encephalocele in a 23 months old infant. Int J Pediatr Otorhinolaryngol 69:1007–1009
Woodworth BA, Schlosser RJ, Faust RA, Bolger WE (2004) Evolutions in the management of congenital intranasal skull base defects. Arch Otolaryngol Head Neck Surg 130:1283–1288
Van Den Abbeele T, Elmaleh M, Herman P et al (1999) Transnasal endoscopic repair of congenital defects of the skull base in children. Arch Otolaryngol Head Neck Surg 125:580–584
Kanowitz SJ, Bernstein JM (2006) Pediatric meningoencephaloceles and nasal obstruction: a case for endoscopic repair. Int J Pediatr Otorhinolaryngol 70:2087–2092
Banu MA, Guerrero-Maldonado A, McCrea HJ, Garcia-Navarro V, Souweidane MM, Anand VK, Heier L, Schwartz TH, Greenfield JP (2014) Impact of skull base development on endonasal endoscopic surgical corridors. J Neurosurg Pediatr 13:155–169
Tatreau JR, Patel MR, Shah RN, McKinney KA, Wheless SA, Senior BA, Ewend MG, Germanwala AV, Ebert CS Jr, Zanation AM (2010) Anatomical considerations for endoscopic endonasal skull base surgery in pediatric patients. Laryngoscope 120:1730–1737
Mohindra S, Mohindra S, Patro SK (2015) Successful endoscopic endonasal repair of nasal meningoencephalocele in a 21-day-old neonate. Allergy Rhinol 6:125–128
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
nil.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Mohindra, S., Mohindra, S., Mahendru, S. et al. Endoscopic management of congenital nasal meningoencephaloceles: a short series of 15 paediatric cases. Childs Nerv Syst 36, 3059–3062 (2020). https://doi.org/10.1007/s00381-020-04649-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00381-020-04649-9