Surgical nuances for the endoscopic endonasal transpterygoid approach to lateral sphenoid sinus encephaloceles.
Lateral sphenoid encephaloceles of the Sternberg canal are rare entities and usually present with spontaneous CSF rhinorrhea. Traditionally, these were treated via transcranial approaches, which can be challenging given the deep location of these lesions. However, with advancements in endoscopic skull base surgery, including improved surgical exposures, angled endoscopes and instruments, and novel repair techniques, these encephaloceles can be resected and successfully repaired with purely endoscopic endonasal approaches. In this report, the authors review the endoscopic endonasal transpterygoid approach to the lateral recess of the sphenoid sinus for repair of temporal lobe encephaloceles, including an overview of the surgical anatomy from an endoscopic perspective, and describe the technical operative nuances and surgical pearls for these cases. The authors also present 4 new cases of lateral sphenoid recess encephaloceles that were successfully treated using this approach.
Department of Neurological Surgery, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, New Jersey 07101, USA.
Richard F
RF
Schmidt
Osamah J
OJ
Choudhry
Joseph
J
Raviv
Soly
S
Baredes
Roy R
RR
Casiano
Jean Anderson
JA
Eloy
James K
JK
Liu
D004677:Encephalocele / Q000175:diagnosis / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009296:Nasal Cavity / Q000601:surgery*; D013101:Sphenoid Sinus / Q000473:pathology / Q000601:surgery*