title: Endoscopic transpterygoid approach and skull base repair after sphenoid meningoencephalocele resection. Our experience.
abstract: OBJECTIVE
  Cerebrospinal fluid leaks associated to meningoencephaloceles of the sphenoid lateral recess are rare entities. A congenital bony defect at this level results in the persistence of Sternberg's canal, or a lateral craniopharyngeal canal, which is supposed to be the origin of these lesions. Our objective was to show that the endoscopic transpterygoid approach is an effective technique for their treatment.
  
  
  METHODS
  We present a series of 5 cases of meningoencephaloceles of the sphenoid lateral recess treated with endoscopic sinus surgery (4 women and one man; mean age=59, range 37-72 years). Cerebrospinal fluid rhinorrhoea was present in all of them and they all underwent a transpterygoid approach with reconstruction of the skull base. We describe the surgical technique and review the literature.
  
  
  RESULTS
  No complications were observed during surgery or the postoperative period. After a mean follow-up of 81 months, only one recurrence was seen.
  
  
  CONCLUSIONS
  The transpterygoid approach has proven to be effective for the treatment of meningoencephaloceles of the sphenoid lateral recess. Providing wide access to identify the defect, followed by meningoencephalocele ablation, is the key for successful surgery.
authors: Servicio de Otorrinolaringología, Hospital Universitario Parc Taulí, Sabadell, Barcelona, España.
authors: Àngels
authors: À
authors: Martínez Arias
authors: Unidad de Base de Cráneo, Servicio de Otorrinolaringología, Hospital Clínic Barcelona, Barcelona, España.
authors: Manuel
authors: M
authors: Bernal-Sprekelsen
authors: Servicio de Otorrinolaringología Althaia Xarxa Assistencial, Manresa, España.
authors: Elena
authors: E
authors: Rioja
authors: Servicio Neurocirugía, Hospital Clínic, Barcelona, España.
authors: Joaquim
authors: J
authors: Enseñat
authors: Laboratorio de Neuroanatomía quirúrgica, Hospital Clínic, Facultad de Medicina, Universidad de Barcelona, Barcelona, España.
authors: Alberto
authors: A
authors: Prats-Galino
authors: Unidad de Base de Cráneo, Servicio de Otorrinolaringología, Hospital Clínic Barcelona, Barcelona, España. Electronic address: isamalobid@gmail.com.
authors: Isam
authors: I
authors: Alobid
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology / Q000601:surgery; D006259:Craniocerebral Trauma / Q000150:complications; D004677:Encephalocele / Q000000981:diagnostic imaging / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000000981:diagnostic imaging / Q000601:surgery; D016920:Meningitis, Bacterial / Q000209:etiology; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D019651:Plastic Surgery Procedures / Q000379:methods*; D012008:Recurrence; D019291:Skull Base / Q000000981:diagnostic imaging / Q000601:surgery*; D013100:Sphenoid Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014420:Turbinates / Q000601:surgery
keywords: Base del cráneo; Canal de Sternberg; Cerebrospinal fluid leak; Cirugía endoscópica nasosinusal; Endoscopic sinus surgery; Fístula de líquido cefalorraquídeo; Meningoencefalocele; Meningoencephalocele; Receso lateral de esfenoides; Skull base; Sphenoid lateral recess; Sternberg's canal; Transpterigoideo; Transpterygoid