Endoscopic treatment of traumatic basal encephaloceles: a report of 8 cases.
OBJECTIVE
Basal encephaloceles are rare entities that can present as congenital diseases; however, traumatic lesions due to head injuries or iatrogenic causes have been described in the literature. In this study the authors aimed to define placement techniques for free grafts in repairing traumatic basal encephaloceles and to describe the long-term effectiveness of endoscopic treatment.


METHODS
Between September 1997 and December 2006, 8 patients with traumatic encephaloceles underwent endoscopic surgery. A free graft following an underlay (2 cribriform plate and 4 ethmoid fovea defects) or obliteration (2 sphenoid defects) procedure was used as the repair material.


RESULTS
All traumatic basal encephaloceles with the associated skull base defects and cerebrospinal fluid (CSF) leakage were successfully treated via the endoscopic approach. There were no major complications or recurrence of meningitis or leakage of CSF encountered after an average follow-up of 77 months.


CONCLUSIONS
Long-term follow-up results demonstrated that endoscopic surgery was suitable for the treatment of traumatic basal encephaloceles. The underlay procedure is more appropriate than the overlay procedure in repairing large defects of the anterior skull base. Meticulous manipulations of the endoscope following precise autograft placement are mandatory for the successful repair of traumatic basal encephaloceles.
Lee
Ta-Jen
TJ
Department of Otolaryngology, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan.
Chang
Po-Hung
PH
Huang
Chi-Che
CC
Chuang
Chi-Cheng
CC
D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D001930:Brain Injuries / Q000150:complications*; D016380:Brain Tissue Transplantation / Q000379:methods; D004677:Encephalocele / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D016920:Meningitis, Bacterial / Q000517:prevention & control; D008875:Middle Aged; D044583:Neuroendoscopy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome