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Middle Fossa Approach to a Temporosphenoidal Encephalocele — Technical Note —

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Author(s)
Jae Eun KWONEalmaan KIM
Keimyung Author(s)
Kim, El
Department
Dept. of Neurosurgery (신경외과학)
Journal Title
Neurologia Medico-Chirurgica
Issued Date
2010
Volume
50
Issue
5
Keyword
intrasphenoidal encephalocelecerebrospinal fluid rhinorrheameningitisskull base surgery
Abstract
Temporosphenoidal encephalocele (TSE) is a rare entity caused by herniation of the anteromedial temporal lobe into the sphenoid sinus (SS) through a middle fossa (MF) defect. A 45-year-old woman presented with a spontaneous TSE manifesting as a 4-year history of recurrent cerebrospinal fluid rhinorrhea and meningitis. Coronal computed tomography showed a skull defect in the superior wall of the right lateral recess of the SS. This homogeneous intrasphenoidal lesion appeared hypointense on T1-weighted magnetic resonance (MR) imaging and hyperintense on T2-weighted MR imaging. The patient underwent a frontotemporal craniotomy and extradural MF exploration. The encephalocele was amputated and the temporal base dura primarily sutured and reinforced with fat graft. The MF hole was plugged with temporalis fascia and a calvarial graft layered over the bone defect. Histological examination confirmed meningoencephalocele. Rhinorrhea resolved and the patient remained asymptomatic. Resection of an anteromedial TSE and closure of the craniodural defect in the MF floor via a less invasive extradural skull base approach is effective.
Keywords: intrasphenoidal encephalocele, cerebrospinal fluid rhinorrhea, meningitis, skull base surgery
Keimyung Author(s)(Kor)
김엘
Publisher
School of Medicine
Citation
Jae Eun KWON and Ealmaan KIM. (2010). Middle Fossa Approach to a Temporosphenoidal Encephalocele — Technical Note —. Neurologia Medico-Chirurgica, 50(5), 434–438. doi: 10.2176/nmc.50.434
Type
Article
ISSN
0470-8105
DOI
10.2176/nmc.50.434
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33500
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학)
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