title: Transalar transsphenoidal meningoencephalocele presenting in the form of recurrent meningitis: Report of two cases and discussion of the diagnosis and treatment.
abstract: BACKGROUND
  Skull base meningoencephaloceles are rare congenital malformations. The two cases of transalar transsphenoidal malformation reported here differ from the classical transsphenoidal meningoencephalocele.
  
  
  METHODS
  Case 1 was a three-and-a-half-year-old boy and case 2 was a 36-year-old man. Both cases presented with clinical features of recurrent meningitis. Surgical management of case 1 was performed via an intradural infratemporal fossa craniotomy with reoperation 2years later. In the second case, surgery was initially performed via an endonasal approach and then via pterional craniotomy. Reoperation via Sekhar's transpetrosal approach was also a failure. Only closure of the trigeminal-pontine angle via a suboccipital retrosigmoid approach allowed repair of the defect.
  
  
  CONCLUSIONS
  Surgical access to the pterygopalatine fossa is complex due to its anatomical position and its anatomical relations with nerves and vessels. An endoscopic approach appears to be a valuable alternative to classical craniotomy.
  
  
  CONCLUSIONS
  In the two cases reported here, neurosurgery allowed lasting closure of the defect.
authors.affiliation: Service d'ORL-CCF, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France.
authors.forename: A
authors.initials: A
authors.lastname: Zoghlami
authors.affiliation: Service d'ORL-CCF, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France.
authors.forename: N
authors.initials: N
authors.lastname: Bon Mardion
authors.affiliation: Service d'imagerie, centre Henri-Becquerel, rue d'Amiens, 76000 Rouen, France.
authors.forename: F
authors.initials: F
authors.lastname: Callonnec
authors.affiliation: Service d'ORL-CCF, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France.
authors.forename: D
authors.initials: D
authors.lastname: Dehesdin
authors.affiliation: Service de neurochirurgie, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France.
authors.forename: F
authors.initials: F
authors.lastname: Proust
authors.affiliation: Service d'ORL-CCF, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France. Electronic address: Jean-Paul.Marie@chu-rouen.fr.
authors.forename: J-P
authors.initials: JP
authors.lastname: Marie
mesh_terms: D000328:Adult; D065634:Cerebrospinal Fluid Leak / Q000209:etiology / Q000601:surgery; D002675:Child, Preschool; D004677:Encephalocele / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008297:Male; D008586:Meningitis, Pneumococcal / Q000209:etiology*; D008588:Meningocele / Q000175:diagnosis* / Q000601:surgery; D012008:Recurrence; D019291:Skull Base / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery
keywords: Encephalocele; Malformation; Recurrent meningitis; Skull base; Sphenoid