Kantas Ilias, Tzindros Georgios, Papadopoulou Anna, Marangos Nikolaos
Center of Otorhinolaryngology, Head & Neck and Skull Base Surgery, Euroclinic Athens, Athens, Greece.
Skull Base. 2006 May;16(2):117-22. doi: 10.1055/s-2006-934110.
Trans-sphenoid anterobasal temporal lobe meningoceles are rare and can be associated with temporal lobe epilepsy or recurrent meningitis. Surgical treatment is described via complicated infratemporal or intracranial approaches with high morbidity. A 32-year-old man presented with an 18-year history of two types of seizures and confirmed epileptic activity in electroencephalogram. A trans-sphenoid meningocele in the left pterygopalatine fossa was found on computed tomography and magnetic resonance imaging. A midfacial degloving was chosen instead of a large neurosurgical approach to remove it and to repair the dura defect with lyophilized dura, collagen, and abdominal fat. The postoperative course was uneventful without visible scars and the patient remains free of seizures without antiepileptic medication 3 years after surgery. Although midfacial degloving is not described yet as a treatment of trans-sphenoid meningoceles, this approach proved to be fast, safe, effective, and reliable and should be considered as the only alternative to large external approaches.
经蝶窦前基底颞叶脑膜膨出罕见，可伴有颞叶癫痫或复发性脑膜炎。手术治疗需通过复杂的颞下或颅内入路，并发症发生率高。一名32岁男性有18年两种类型癫痫发作史，脑电图证实有癫痫活动。计算机断层扫描和磁共振成像发现左侧翼腭窝有经蝶窦脑膜膨出。选择面中部去骨瓣术而非大型神经外科手术入路来切除脑膜膨出并用冻干硬脑膜、胶原蛋白和腹部脂肪修复硬脑膜缺损。术后过程顺利，无可见瘢痕，患者术后3年未服用抗癫痫药物，癫痫未再发作。尽管面中部去骨瓣术尚未被描述为经蝶窦脑膜膨出的治疗方法，但该方法被证明快速、安全、有效且可靠，应被视为大型外部入路的唯一替代方法。
