ENDOSCOPIC TREATMENT OF ANTERIOR SKULL BASE MENINGOENCEPHALOCELES

OBJECTIVES: Encephaloceles, meningoceles and meningoencephalocels represent only one aspect of the wide spectrum of skull base defects. The cause of these lesions is generally congenital or related to spontaneous or traumatic injury. Endoscopic treatment allows safe management of cerobrospinal fluid (CSF) leaks endonasally. We report our experience in an endonasal approach for meningoencephalocel. METHODS: Between October 2007 and January 2009, 4 patients with spontaneous basal encephalomeningoceles underwent enodoscopic surgery at the Depatment of Otorhinolaryngology of San Raffaele Hospital, Milan. In all cases a fluorescein test and computed tomography were performed. All patients were treated with an endoscopic procedure. RESULTS: All 4 patients underwent an endoscopic approach with a multilayer reconstructive technique following an underlay procedure. One recurrence of CSF leak was observed on postoperative day 5 that needed revision surgery. No other major complcations or recurrences were observed after a follow-up from 2-17 months. CONCLUSION: An intranasal endoscopic approach is safe and effective in the surgical management of spontaneous encephalomeningoceles. In this small patient population, the short-term success rate was 100%.