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J Neurol Surg B Skull Base 2014; 75(02): 096-103
DOI: 10.1055/s-0033-1358374
Original Article
Georg Thieme Verlag KG Stuttgart · New York

The Transpalatal Approach to Repair of Congenital Basal Skull Base Cephaloceles

Stephen R. Hoff
1   Department of Otolaryngology - Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
2   Division of Pediatric Otolaryngology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, United States
,
Michael S. B. Edwards
3   Division of Pediatric Neurosurgery, Department of Neurosurgery, Stanford University School of Medicine and Lucile Packard Children's Hospital, Stanford, California, United States
,
C. Martin Bailey
4   Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
,
Peter J. Koltai
5   Division of Pediatric Otolaryngology, Department of Otolaryngology – Head and Neck Surgery, Stanford University School of Medicine and Lucile Packard Children's Hospital, Stanford, California, United States
› Author Affiliations
Further Information

Publication History

02 August 2013

30 August 2013

Publication Date:
10 February 2014 (online)

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Abstract

Basal skull base herniations, including meningoceles and encephaloceles, are rare and may present with characteristic facial and neurologic features. The traditional craniotomy approach has known morbidity, and nasal endoscopy may not allow for control of large posterior basal defects, especially in newborns. We present two cases of successful repair of basal transsphenoidal meningoceles using an oral-transpalatal approach. The first patient with an intact palate presented with respiratory distress, and a palatectomy was performed for access to the skull base. The second patient had a large basal herniation that was reduced through a congenital midline cleft palate, and a calvarial bone graft was used to repair the defect. A literature search revealed 10 previous successful cases using the transpalatal repair, which allows for excellent access, low morbidity, and a team-oriented method to skull base surgery.

Keywords

transpalatal - encephalocele - congenital - endonasal

Note

Presented at the 2012 North American Skull Base Society Annual Meeting, Las Vegas, NV.


 

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