[Endoscopic endonasal surgery for meningoencephalocele].

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi

Department of Otorhinolaryngology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China.

Published: February 2008

Objective: To investigate the management experience with transnasal endoscopic technique for meningoencephalocele.

Methods: Nine patients with endonasal encephalomeningocele were managed by transnasal endoscopic surgery, and the skull base defect was repaired by fascia.

Results: Eight cases were successfully managed at the time of the first operation, and no relapse case was found during 1 to 4 years follow-up. Only one case of a two years old child relapsed with cerebrospinal fluid rhinorrhea one month after operation. During the second operation, titanium mesh uncovering was found, and replacement of titanium mesh by fascia via skull base defect was done, without relapse one and half years after the second operation. Another case of a one year old child got a fever one day after operation, but no white blood cell was found in the cerebrospinal fluid, and the temperature recovered to normal after release cerebrospinal fluid management. There were no complications of cranial infection, hemorrhage, edema and water retention in brain to be found in all cases.

Conclusions: It is not only minimally invasive, safety and efficiency of transnasal endoscopic technique for meningoencephalocele, but also had a clear operating view for better recolonization of the position of leak and the structure of operating field, therefore, transnasal endoscopic technique is the first choice for the management of endonasal encephalomeningocele. The accurate localization of leak and selection of the appropriate repairing materials are the key point for the successful operation.

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