Abstract
Objective: To introduce an alternative surgical approach for repair of the transsellar transsphenoidal meningoencephaloceles (TTSME), which are extremely rare CNS defects and a challenge in surgical management because of the vicinity and even involvement of vital structures of midline diencephalon. Study Design: A case report introducing an alternative approach. Material and Methods: A 36-year-old woman with pituitary dwarfism presented complaining of nasal obstruction. CT scan showed a bony defect in the sellar floor and sphenoid sinus with huge nasopharyngeal mass. In MRI, a true TTSME with third ventricle involvement was detected. Endoscopic endonasal approach was used for repair. The sac was partially removed after close inspection of its contents, and the defect was reconstructed with fat and facial graft, and buttressed with titanium mesh and septal flap. Results: Visual field improvement noticed postoperatively. No complication including postoperative cerebrospinal fluid (CSF) leak or relapse was encountered in 18 months follow-up. Conclusion: Endoscopic endonasal approach was successfully used for repair of a true TTSME. As the case had a huge sac, partial resection of the sac was adopted instead of reduction to not put the optic chiasma in jeopardy.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Journal of Neurological Surgery Part B: Skull Base
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
