Endonasal Management of Skull Base Defects: Meningoceles and Meningoencephaloceles
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Abstract
Introduction
Meningoceles and menigoencephaloceles result from herniation of the meninges, with or without brain tissue, through defects in the skull base.
Objectives: To determine the success rate of skull base repair for meningoceles and menigoencephaloceles using an endonasal approach assisted by endoscopes, and to establish an algorithm for the preoperative topographic diagnosis of these lesions.
Methods: Patients treated for skull base meningoceles and menigoencephaloceles using anendonasal approach assisted by endoscopes between January 2010 and March 2024 wereincluded. Reconstruction of the defect was performed using a multilayer technique withautologous grafts and local flaps.
Results: Ten patients were treated: nine with meningoceles and one with a meningoencephalocele. Three were located in the sphenoid sinus, six in the cribriform plate of the ethmoid bone, and one in the frontal sinus.
The success rate we achieved in repairing the skull base defect was 90%.
Conclusions: The success rate we achieved in repairing skull base defects caused by meningoceles and meningoencephaloceles using an endonasal approach was
90%.
Computed tomography and contrast-enhanced magnetic resonance imaging (MRI) with a protocol to visualize the olfactory bulb were very useful in diagnosing the site of the lesions at the level of the cribriform plate of the ethmoid bone.
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