The surgical correction of fronto-ethmoidal meningo-encephaloceles.
One-stage correction of fronto-ethmoidal meningo-encephaloceles and related stigmata, via an orbito-cranial approach, is recommended. A bifrontal craniotomy is only required when simultaneous correction of hypertelorism is to be undertaken. A combined intra- and extracranial approach is essential. The possibility of a high relapse rate for repaired fronto-ethmoidal meningo-encephaloceles, together with the possibility of prolonged postsurgical cerebrospinal fluid leakage, meningitis and other complications is invited when either a transcranial bifrontal craniotomy surgical approach, or an extracranial approach via the facial lesion, is undertaken alone. Modification of existing craniofacial surgical approaches in order to avoid a frontal craniotomy, allowed for good repair of the encephalocele together with significant benefits in terms of simplification of the surgical procedure, operating time, blood loss, frontal lobe retraction and complications.
Lello
G E
GE
Dept. of Maxillofacial and Oral Surgery, Medical University of Southern Africa, Pretoria.
Sparrow
O C
OC
Gopal
R
R
D016025:Bone Transplantation; D002675:Child, Preschool; D003399:Craniotomy / Q000379:methods*; D004677:Encephalocele / Q000601:surgery*; D005004:Ethmoid Bone / Q000601:surgery; D005500:Follow-Up Studies; D005624:Frontal Bone / Q000601:surgery; D006801:Humans; D007223:Infant; D008588:Meningocele / Q000601:surgery*; D009666:Nose / Q000601:surgery; D009915:Orbit / Q000601:surgery; D010027:Osteotomy / Q000379:methods; D011183:Postoperative Complications; D012008:Recurrence