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European Archives of Oto-Rhino-Laryngology

, Volume 275, Issue 11, pp 2727–2731 | Cite as

Endoscopic management of paediatric meningoencephaloceles: a case series

  • M. StavrakasEmail author
  • P. D. Karkos
  • S. Triaridis
  • J. Constantinidis
Rhinology

Abstract

Introduction

Congenital meningoencephaloceles represent a rare clinical entity, with its frequency being around 1 out of 4000–5000 live births. They usually present as a midline mass and the differential diagnosis includes dermoids, encephaloceles, and gliomas. Although the standard coronal approach with frontal craniotomy and pericranial flap has been considered the preferred method for several years, it is associated with risks and prolonged hospitalization. The endoscopic procedure is gaining ground and we are aiming to present our experience from five cases that were treated endoscopically.

Materials and methods

Five cases of paediatric meningoencephaloceles (age ranging from 2.5 to 10 years) were treated in our department between the years 2007–2017. Four children had a congenital and one child a post-traumatic meningoencephalocele. The presenting symptoms included nasal obstruction, meningitis and CSF leak. All patients had pre-operative imaging with CT and MRI scans and the preferred method of repair was multi-layered closure.

Results

All our patients had uneventful recovery, without any post-operative complications. The follow-up period ranges from 39 to 98 months. All five patients remain asymptomatic and recurrence-free.

Conclusion

Endoscopic management of paediatric meningoencephaloceles is a reliable and safe approach and it is known to have no adverse effects on facial growth. It carries a satisfactory success rate, reduces the in-hospital stay with lower cost of treatment, better cosmesis and lower morbidity than external procedures. It requires multidisciplinary team setting in a tertiary centre with experienced endoscopic anterior skull base surgeons. Pre-operative assessment and post-operative care are of paramount importance and larger series need to be studied to reach safe conclusions and establish management guidelines.

Keywords

Meningocele Meningoencephalocele Paediatric otolaryngology Skull base Endoscopic 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.ENT DepartmentΑristotle University of Thessaloniki, AHEPA HospitalThessalonikiGreece
  2. 2.ENT DepartmentDerriford HospitalPlymouthUK

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