MULTIDISCIPLINARY APPROACH OF AN FRONTOETHMOIDAL
Authors:
Dr. Mariana Cebotari, Dr. Isabel Vazquez, Dr. Teresa Burnay, Dr. Ligia Coelho, Dr. Jose Bilhoto
Affiliation:
Centro Hospitalar Universitário São João, Porto, Portugal
Doi: 10.54936/haoms242p81
ABSTRACT:
Objectives: The purpose of this paper is to report a case of a frontoethmoidal meningoencephalocele.
Materials and Methods: Encephalocele are rare congenital malformations, that can be divided in two groups: meningocele and meningoencephalocele. Congenital meningoencephalocele is a herniation of brain and meninges through a skull base defect. In frontoethmoidal meningoencephalocele, the herniation occurs through a defect in the anterior cranium, between the frontal and ethmoidal bones. This entity is very prevalent in Asia, but relatively rare in Western Europe, Japan, Australia, and North America.
Results: The authors present the case of a 11-month-old female infant who was transferred to Portugal from Guinea- Bissau with a frontonasal mass since birth that increased in size, causing obvious facial disfigurement. The patient didn’t present breathing difficulties, nasal obstruction or active nasal fluid leak. She was admitted for further investigation. CT scan and MRI showed an extensive bony defect with herniation of meninges and brain matter of both frontal lobes thru the frontal and orbital wall defect. The patient underwent a surgical correction with excision of the herniated tissue, cranioplasty with resorbable plating system and reconstruction of the nasal defect with frontal bone flap tissue, and local skin flap. She returned 10 days after she was discharged with a frontonasal skin infection and admitted for antibiotic therapy. Control CT and MRI showed no signs of CSF leakage and she responded well to the treatment.
Conclusion: The goal of the treatment is to return the cerebral components in to the cranial cavity along with amputation of dysplastic tissue and closure of the bony defect. The ideal timing of the surgical reconstruction is controversial. Patient’s age, presenting symptoms and potential complications should be considered. Early surgery has advantages like decreasing the risk of meningitis and other infections, enabling nasal respiration and preventing further craniofacial deformities.
KEY WORDS:
Authors:
Dr. Mariana Cebotari, Dr. Isabel Vazquez, Dr. Teresa Burnay, Dr. Ligia Coelho, Dr. Jose Bilhoto
Affiliation:
Centro Hospitalar Universitário São João, Porto, Portugal
Doi: 10.54936/haoms242p81
ABSTRACT:
Objectives: The purpose of this paper is to report a case of a frontoethmoidal meningoencephalocele.
Materials and Methods: Encephalocele are rare congenital malformations, that can be divided in two groups: meningocele and meningoencephalocele. Congenital meningoencephalocele is a herniation of brain and meninges through a skull base defect. In frontoethmoidal meningoencephalocele, the herniation occurs through a defect in the anterior cranium, between the frontal and ethmoidal bones. This entity is very prevalent in Asia, but relatively rare in Western Europe, Japan, Australia, and North America.
Results: The authors present the case of a 11-month-old female infant who was transferred to Portugal from Guinea- Bissau with a frontonasal mass since birth that increased in size, causing obvious facial disfigurement. The patient didn’t present breathing difficulties, nasal obstruction or active nasal fluid leak. She was admitted for further investigation. CT scan and MRI showed an extensive bony defect with herniation of meninges and brain matter of both frontal lobes thru the frontal and orbital wall defect. The patient underwent a surgical correction with excision of the herniated tissue, cranioplasty with resorbable plating system and reconstruction of the nasal defect with frontal bone flap tissue, and local skin flap. She returned 10 days after she was discharged with a frontonasal skin infection and admitted for antibiotic therapy. Control CT and MRI showed no signs of CSF leakage and she responded well to the treatment.
Conclusion: The goal of the treatment is to return the cerebral components in to the cranial cavity along with amputation of dysplastic tissue and closure of the bony defect. The ideal timing of the surgical reconstruction is controversial. Patient’s age, presenting symptoms and potential complications should be considered. Early surgery has advantages like decreasing the risk of meningitis and other infections, enabling nasal respiration and preventing further craniofacial deformities.
KEY WORDS: