Martínez Arias À, Bernal-Sprekelsen M, Rioja E, Enseñat J, Prats-Galino A, Alobid I. Endoscopic transpterygoid approach and skull base repair after sphenoid meningoencephalocele resection. Our experience.
ACTA OTORRINOLARINGOLOGICA ESPANOLA 2014;
66:1-7. [PMID:
25052487 DOI:
10.1016/j.otorri.2014.03.008]
[Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 03/27/2014] [Accepted: 03/28/2014] [Indexed: 10/25/2022]
Abstract
INTRODUCTION AND OBJECTIVES
Cerebrospinal fluid leaks associated to meningoencephaloceles of the sphenoid lateral recess are rare entities. A congenital bony defect at this level results in the persistence of Sternberg's canal, or a lateral craniopharyngeal canal, which is supposed to be the origin of these lesions. Our objective was to show that the endoscopic transpterygoid approach is an effective technique for their treatment.
METHODS
We present a series of 5 cases of meningoencephaloceles of the sphenoid lateral recess treated with endoscopic sinus surgery (4 women and one man; mean age=59, range 37-72 years). Cerebrospinal fluid rhinorrhoea was present in all of them and they all underwent a transpterygoid approach with reconstruction of the skull base. We describe the surgical technique and review the literature.
RESULTS
No complications were observed during surgery or the postoperative period. After a mean follow-up of 81 months, only one recurrence was seen.
CONCLUSIONS
The transpterygoid approach has proven to be effective for the treatment of meningoencephaloceles of the sphenoid lateral recess. Providing wide access to identify the defect, followed by meningoencephalocele ablation, is the key for successful surgery.
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