title: Transsphenoidal meningoencephalocele associated with cleft lip and palate: challenges for diagnosis and surgical treatment.
abstract: OBJECTIVE
  The aim of this study was to highlight the challenges for early diagnosis and the difficulties observed in surgical treatment of patients with transsphenoidal meningoencephalocele associated with cleft lip and/or palate.
  
  
  METHODS
  We evaluated six male patients treated over the course of 4 years. Five patients presented encephalic herniation with nonfunctional brain tissue; one of these presented herniation of the pituitary gland and cerebral ventricles.
  
  
  RESULTS
  All the patients received surgical treatment for the cleft lip and/or palate. Only one patient underwent repair of the meningoencephalocele, via nasal endoscopy. There were no postprocedural clinical or surgical complications.
  
  
  CONCLUSIONS
  The tendency is to avoid neurosurgery, opting for periodic follow-up with magnetic resonance imaging. In the presence of cleft palate, palatoplasty is essential to protect the meningoencephalocele.
authors.affiliation: UFRJ, Praia de Botafogo, Rio de Janeiro 22250-040, Brazil. diogo@openlink.com.br
authors.forename: Diogo
authors.initials: D
authors.lastname: Franco
authors.forename: Nivaldo
authors.initials: N
authors.lastname: Alonso
authors.forename: Renata
authors.initials: R
authors.lastname: Ruas
authors.forename: Renato
authors.initials: R
authors.lastname: da Silva Freitas
authors.forename: Talita
authors.initials: T
authors.lastname: Franco
mesh_terms: D002971:Cleft Lip / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D002972:Cleft Palate / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D004677:Encephalocele / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D004724:Endoscopy; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008588:Meningocele / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D013100:Sphenoid Bone / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome