The Endonasal Endoscopic Management of Pediatric Anterior Meningoencephaloceles , A Tertiary Care Hospital Experience

AlGhamdi, Shatha Yanalah; AlHassan, Fatimah; Al-khatib, Abdulrahman; Almomen, Ali

doi:10.21608/pajn.2023.223317.1100

The Endonasal Endoscopic Management of Pediatric Anterior Meningoencephaloceles , A Tertiary Care Hospital Experience

Document Type : Original Articles

Authors

¹ College of Medicine , King Faisal University, Eastern Province, AlAhsa, P.O. Box 400 - Post Code 31982, Saudi Arabia

² ENT Resident, Department of Surgery, King Fahad Specialist Hospital, Al Muraikebat Area, Ammar Bin Thabet Street, PO Box 15215, Dammam 31444, Saudi Arabia.:

³ ENT Department, King Fahad Specialist Hospital, Al Muraikebat Area, Ammar Bin Thabet Street, PO Box 15215, Dammam 31444, Saudi Arabia.:

⁴ Consultant, Rhinology &Skull base Surgery, ENT Department, King Fahad Specialist Hospital, Al Muraikebat Area, Ammar Bin Thabet Street, PO Box 15215, Dammam 31444, Saudi Arabia.

10.21608/pajn.2023.223317.1100

Abstract

Introduction:
Skull base defects considered one of the rarest conditions in children, the diagnosis and management of skull base defects in pediatrics are challenging. These defects can be congenital or acquired in etiology.
Aim:
To review our experience with the endoscopic endonasal management of pediatric Meningoencephaloceles and anterior skull base defects in a tertiary referral hospital.
Methods:
A retrospective study involving 6 pediatric patients (age ranging from 2-months to 15-years ) who underwent endoscopic endonasal repair of sinonasal meningoencephaloceles excision and skull base reconstruction between the period of 2010 and 2020
Results:
A total of 6 pediatric patients with main presenting symptoms of nasal obstruction, CSF leak, and meningitis. All patients underwent pre-operative imaging and had a successful excision of their meningoencephaloceles and skull base repair using the image guided endoscopic endonasal approach with no post-operative complications.The follow-up period ranges from 2 to 10 years. All of our patients were asymptomatic and recurrence-free during the follow-up period with 100% success rate.
Conclusion:
A careful history, endoscopic examination and radiological investigations are important for accurate diagnosis and treatment in pediatric meningoencephaloceles. The endoscopic endonasal approach is the method of choice in repairing anterior skull base defects in pediatric patients. The advantages of this approach are direct visualization, minimally invasive, safe with low morbidities and short hospital stay.

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