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Transnasal Endoscopic Repair of Congenital Defects of the Skull Base in Children
Thierry Van Den Abbeele, MD, PhD;
Monique Elmaleh, MD;
Philippe Herman, MD, PhD;
Martine François, MD;
Philippe Narcy, MD
Arch Otolaryngol Head Neck Surg. 1999;125:580-584.
Objective To examine imaging findings and methods of endoscopic treatment of congenital skull base defects in children.
Design Retrospective study and case series.
Setting Academic tertiary care center.
Patients Four patients (aged 12 and 14 months and 8 and 13 years) were included from 1995 to 1997. Three presented with a nasal glioma, which was recurrent in 1 case. The fourth patient presented with bacterial meningitis due to a spontaneous cerebrospinal fluid leak. Computed tomography and magnetic resonance imaging were used to locate the defect of the skull base.
Intervention Transnasal endoscopic resection of the glioma or the meningocele, with immediate repair of the skull base defects using free mucosal flaps and/or pediculized mucosal flaps and/or conchal cartilage together with fibrin glue and nasal packing during a 3-week period.
Results None of the 4 patients has experienced recurrent cerebrospinal fluid leaks or postoperative meningitis.
Conclusions The transnasal endoscopic repair of congenital meningoceles is a reliable technique in select pediatric patients. Computed tomography and magnetic resonance imaging provide information that can be used to help the surgical procedure.
From the Departments of Pediatric Otolaryngology (Drs Van Den Abbeele, François, and Narcy) and Pediatric Radiology (Dr Elmaleh), Robert Debré Hospital, and the Department of Otolaryngology, Lariboisière Hospital (Dr Herman), Paris, France.
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