Case Report
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Ethmoidal meningoencephalocele and cerebrospinal fluid leak after septoplasty: a rare complication

Year 2017, Volume: 7 Issue: 2, 108 - 111, 30.09.2017

Abstract

A 24-year-old man referred to our clinic with complaint of intermittent
right-sided watery rhinorrhea. Patient underwent nasal septoplasty one
year ago and rhinorrhea occurred two weeks after the surgery. Rhinorrhea
was ignored and then patient developed meningitis two months after the
surgery. Subsequently, meningoencephalocele formation developed. In this
case report, we present a case of meningoencephalocele associated with
cerebrospinal fluid leak diagnosed one year after the septoplasty.
Septoplasty is usually regarded as a relatively safe operation. However,
forceful maneuvers to perpendicular lamina of the ethmoid bone may
cause breakdown of the skull base structures, particularly the
horizontal lamella of the cribriform plate. When this occur, immediate
management is necessary to prevent intracranial complications including
meningitis, intracranial abscess, and pneumocephalus. Delay in the
diagnosis of such injury may cause erosion of the bone and gradual
herniation of the intracranial contents through the skull base defect.

References

  • Bedrosian JC, Anand VK, Schwartz TH. The endoscopic endonasal approach to repair of iatrogenic and noniatrogenic cere- brospinal fluid leaks and encephaloceles to the anterior cranial fossa. World Neurosurg 2014;82(6 Suppl):S86–94. 2. Kerr JT, Chu FWK, Bayles SW. Cerebrospinal fluid rhinorrhea: diagnosis and management. Otolaryngol Clin N Am 2005;38:597– 611. 3. Onerci TM, Ayhan K, O¤retmenoglu O. Two consequtive cases of cerebrospinal fluid rhinorrhea after septoplasty operation. Am J Otolaryngol 2004;25:354–6. Güvenç G, Eren E, Arslanoglu S et al. A rare complication of sep- toplasty: tension penumocephalus without rhinorrhea. J Craniofac Surg 2014;25:e360–1. 5. Gülflen S, Yilmaz C, Aydin E, Koçbiyik A, Alt›nörs N. Meningoencephalocele formation after nasal septoplasty and man- agement of this complication. Turk Neurosurg 2008;18:281–5. 6. Soni RS, Choudhry OJ, Liu JK, Eloy JA. Postoperative cere- brospinal fluid leak after septoplasty: a potential complication of occult anterior skull base encephalocele. Allergy Rhinol (Providence) 2013;4(1):e41–4. 7. Ketcham AS, Han JK. Complications and management of septo- plasty. Otolaryngol Clin North Am 2010;43:897–904. 8. Venkatesan NN, Mattox DE, Del Gaudio JM. Cerebrospinal fluid leaks following septoplasty. Ear Nose Throat J 2014;93:E43–6. 9. Thakar A, Lal P, Verma R. Delayed cerebrospinal fluid leak fol- lowing septoplasty. Ann Otol Rhinol Laryngol 2009;118:636–8. 10. Taveras JM, Ransohoff J. Leptomenigeal cyst of the brain follow- ing trauma with erosion of the skull; a study of seven cases treated by surgery. J Neurosurg 1953;10:233–41. 11. Nyquist GG, Anand VK, Mehra S, Kacker A, Schwartz TH. Endoscopic endonasal repair of anterior skull base non-traumatic cerebrospinal fluid leaks, meningoceles, and encephaloceles. J Neurosurg 2010;113:961–6.
Year 2017, Volume: 7 Issue: 2, 108 - 111, 30.09.2017

Abstract

References

  • Bedrosian JC, Anand VK, Schwartz TH. The endoscopic endonasal approach to repair of iatrogenic and noniatrogenic cere- brospinal fluid leaks and encephaloceles to the anterior cranial fossa. World Neurosurg 2014;82(6 Suppl):S86–94. 2. Kerr JT, Chu FWK, Bayles SW. Cerebrospinal fluid rhinorrhea: diagnosis and management. Otolaryngol Clin N Am 2005;38:597– 611. 3. Onerci TM, Ayhan K, O¤retmenoglu O. Two consequtive cases of cerebrospinal fluid rhinorrhea after septoplasty operation. Am J Otolaryngol 2004;25:354–6. Güvenç G, Eren E, Arslanoglu S et al. A rare complication of sep- toplasty: tension penumocephalus without rhinorrhea. J Craniofac Surg 2014;25:e360–1. 5. Gülflen S, Yilmaz C, Aydin E, Koçbiyik A, Alt›nörs N. Meningoencephalocele formation after nasal septoplasty and man- agement of this complication. Turk Neurosurg 2008;18:281–5. 6. Soni RS, Choudhry OJ, Liu JK, Eloy JA. Postoperative cere- brospinal fluid leak after septoplasty: a potential complication of occult anterior skull base encephalocele. Allergy Rhinol (Providence) 2013;4(1):e41–4. 7. Ketcham AS, Han JK. Complications and management of septo- plasty. Otolaryngol Clin North Am 2010;43:897–904. 8. Venkatesan NN, Mattox DE, Del Gaudio JM. Cerebrospinal fluid leaks following septoplasty. Ear Nose Throat J 2014;93:E43–6. 9. Thakar A, Lal P, Verma R. Delayed cerebrospinal fluid leak fol- lowing septoplasty. Ann Otol Rhinol Laryngol 2009;118:636–8. 10. Taveras JM, Ransohoff J. Leptomenigeal cyst of the brain follow- ing trauma with erosion of the skull; a study of seven cases treated by surgery. J Neurosurg 1953;10:233–41. 11. Nyquist GG, Anand VK, Mehra S, Kacker A, Schwartz TH. Endoscopic endonasal repair of anterior skull base non-traumatic cerebrospinal fluid leaks, meningoceles, and encephaloceles. J Neurosurg 2010;113:961–6.
There are 1 citations in total.

Details

Subjects Health Care Administration
Journal Section Articles
Authors

Abdulkadir İmre This is me

Ercan Pınar This is me

Ahmet Ata Ece This is me

Publication Date September 30, 2017
Submission Date November 6, 2017
Published in Issue Year 2017 Volume: 7 Issue: 2

Cite

APA İmre, A., Pınar, E., & Ece, A. A. (2017). Ethmoidal meningoencephalocele and cerebrospinal fluid leak after septoplasty: a rare complication. ENT Updates, 7(2), 108-111.
AMA İmre A, Pınar E, Ece AA. Ethmoidal meningoencephalocele and cerebrospinal fluid leak after septoplasty: a rare complication. ENT Updates. September 2017;7(2):108-111.
Chicago İmre, Abdulkadir, Ercan Pınar, and Ahmet Ata Ece. “Ethmoidal Meningoencephalocele and Cerebrospinal Fluid Leak After Septoplasty: A Rare Complication”. ENT Updates 7, no. 2 (September 2017): 108-11.
EndNote İmre A, Pınar E, Ece AA (September 1, 2017) Ethmoidal meningoencephalocele and cerebrospinal fluid leak after septoplasty: a rare complication. ENT Updates 7 2 108–111.
IEEE A. İmre, E. Pınar, and A. A. Ece, “Ethmoidal meningoencephalocele and cerebrospinal fluid leak after septoplasty: a rare complication”, ENT Updates, vol. 7, no. 2, pp. 108–111, 2017.
ISNAD İmre, Abdulkadir et al. “Ethmoidal Meningoencephalocele and Cerebrospinal Fluid Leak After Septoplasty: A Rare Complication”. ENT Updates 7/2 (September 2017), 108-111.
JAMA İmre A, Pınar E, Ece AA. Ethmoidal meningoencephalocele and cerebrospinal fluid leak after septoplasty: a rare complication. ENT Updates. 2017;7:108–111.
MLA İmre, Abdulkadir et al. “Ethmoidal Meningoencephalocele and Cerebrospinal Fluid Leak After Septoplasty: A Rare Complication”. ENT Updates, vol. 7, no. 2, 2017, pp. 108-11.
Vancouver İmre A, Pınar E, Ece AA. Ethmoidal meningoencephalocele and cerebrospinal fluid leak after septoplasty: a rare complication. ENT Updates. 2017;7(2):108-11.