A complex therapy for treatment of frontoethmoidal meningoencephalocele in a developing third world country: neurosurgical aspects

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Object

Meningoencephaloceles are congenital malformations that have a high incidence in the population of Southeast Asia. Frontoethmoidal meningoencephaloceles, the most common variety, require surgical treatment. The authors combined neurosurgical and craniofacial approaches for the development of a simple technique that corrects this type of meningoencephalocele in a one-step procedure that has not been discussed in the literature previously.

Methods

In three visits of approximately 1 week each, 30 patients suffering from a frontoethmoidal meningoencephalocele underwent surgery successfully at the Rose Charities Surgical Rehabilitation Center, Kien Khleang, Phnom Penh, Cambodia. To the authors’ knowledge, this is the first reported series of operations in this geographical region to treat meningoencephaloceles at a relatively primitive surgical center. Difficulties faced in this series included tropical conditions, problems ensuring sterility, and limited technical support.

Conclusions

The authors present the neurosurgical highlights and the outcomes in this series of patients. The single approach, via a bicoronal skin incision and small frontobasal trepanation, facilitates closure of the frontal skull defect and resection of the meningoencephalocele (including its extension into the facial area), as well as a satisfactory, one-step correction of the nasal skeleton and telecanthus.

Abbreviation used in this paper: CSF = cerebrospinal fluid.
Article Information

Contributor Notes

Address reprint requests to: Thomas Pinzer, M.D., Klinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus, Fetscherstrasse 74, 01307 Dresden, Germany. email: Thomas.Pinzer@mailbox.tudresden.de.

© AANS, except where prohibited by US copyright law.

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