Spontaneous Intranasal Meningocele: A Case Report

Abstract

Intranasal meningocele is a pathology that occurs as a result of herniation of the meninges in the nasal cavity usually due to defects of the cribriform plate. They are frequently found in the pediatric population as a result of congenital defects at the base of the skull. Intranasal meningoceles are very rare in adults and usually occur as a consequence of trauma. The most obvious symptoms are nasal discharge and obstruction, making diagnosis difficult as they resemble polyps. Intranasal meningoceles may cause serious complications unless promptly diagnosed and treated via surgery. The most commonly used surgical procedure today is the closure of the skull base defect through intranasal route. In our case, the dural defect of our 59-year-old female patient with intranasal meningocele was repaired with this technique. Postoperative 10 months follow-up showed neither cerebrospinal fluid leakage nor other complications. We present this case with a summary of relevant literature.

Keywords

• Ethmoid bone,meningocele,nasal polyp

Spontan İntranazal Meningosel: Bir Olgu Sunumu

Öz

Burun içi meningosel, kribriform plakadaki defekte bağlı olarak meninkslerin burun boşluğuna fıtıklaşması sonucunda ortaya çıkan patolojidir. Bunlar, sıklıkla pediatrik popülasyonda kafatası tabanındaki doğuştan bir defekt nedeniyle bulunur. Burun içi meningosel, erişkinlerde çok nadirdir ve genellikle travma sonucu ortaya çıkar. En belirgin semptom burun akıntısı ve tıkanıklığıdır. Poliplere benzediğinden teşhis edilmeleri zordur. Teşhis edilmediği takdirde ciddi komplikasyonlara yol açarlar. Tedavisi cerrahi olup günümüzde kullanılan cerrahi yöntem intranazal yolla kafa tabanı defektinin kapatılmasıdır. Elli dokuz yaşındaki bir kadın hasta da, meningosele bağlı dural defekt,intranazal yolla kapatıldı. Postoperatif 10 aylık takiplerinde herhangi bir beyin omurilik sıvısı sızıntısı ya da başka bir komplikasyon bildirilmedi. Bu vaka literatür eşliğinde sunuldu. 

Anahtar Kelimeler

• nazal polip,Etmoid kemik,Meningosel,nazal polip

References

1. 1-David DJ. Cephaloceles classification, pathology, and management—a review. J Craniofac Surg. 1993;4(4):192-202.
2. 2-Castaño-Duque CH, Monfort L, Muntané A, de Miquel MA, Pons-Irazaz. Trans-ethmoid meningocele diagnosed in adults abal LC, López-Moreno JL. Rev Neurol. 1997;25(138):230-233.
3. 3-Nager GT. Cephaloceles. Laryngoscope. 1987;7(1):77-84.
4. 4-Kollias SS, Ball WS, Congenital Malformation of Brain Chapter 5. In Pediatric Neuroradiology Ed. Ball WS. Lippincott; 1997:2327-2346.
5. 5-Malik R, Pandya VK, Parteki S. Fronto ethmoidal meningocele. Neuroradiology. 2004;14(4):379-381.
6. 6-Shetty P, Shroff MM, Sahani DV. Evaluation of high-resolution CT and MR cisternography in the diagnosis of cerebrospinal fluid fistula. Am J Neuroradiol. 1998;19633-639
7. 7-İsmi O, Özcan C, Vayısoğlu Y, Koray K, Kuyucu N. Endoscopik Nazal meningocele and CSF Leak Repair using inferior Turbinate Greft. Turkish J Rhinology. 2015;4(1):34-8.
8. 8-Martín C. Martínez CG, Serramito GR, Espinosa RF. Surgical challenge: endoscopic repair of cerebrospinal fluid leak. BMC Res Notes. 2012;5:459.

9. 9-RandolphG. Comprehensive Techniques in CSF Leak Repair and Skull Base Reconstruction.Adv Otorhinolaryngol. 2013;(74):33-41.
10. 10-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(5):961-6