Rajasekar Gopikrishnan, Nair Prakash, Abraham Mathew, Jaiswal Palak
Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
World Neurosurg. 2019 Feb;122:196-202. doi: 10.1016/j.wneu.2018.10.138. Epub 2018 Nov 1.
A persistent craniopharyngeal canal (PCC) is a rare cause of cerebrospinal fluid rhinorrhea in children. The condition often coexists with other midline facial defects, such as cleft palate. Children with PCC may also have pituitary dysfunction or neoplasms, such as craniopharyngiomas within the canal.
A 5-year-old girl presented with bacterial meningitis and active cerebrospinal fluid rhinorrhea from her left nostril. Imaging showed a large nasopharyngeal meningoencephalocele, communicating with the subarachnoid space through a persistent craniopharyngeal canal. An endonasal approach was chosen to excise the PCC and meningoencephalocele and to repair the resulting skull base defect.
The extended endonasal approach can be used to treat PCC with nasopharyngeal encephaloceles in young children. The approach is suitable to address both conditions at the same time. The extended endonasal approach avoids potentially morbid transfacial approaches and can help in earlier recovery after surgery.
持续性颅咽管（PCC）是儿童脑脊液鼻漏的罕见原因。该病症常与其他中线面部缺陷共存，如腭裂。患有PCC的儿童也可能有垂体功能障碍或肿瘤，如管内颅咽管瘤。
一名5岁女孩因细菌性脑膜炎和左侧鼻孔活动性脑脊液鼻漏就诊。影像学检查显示一个大的鼻咽部脑膜脑膨出，通过持续性颅咽管与蛛网膜下腔相通。选择经鼻入路切除PCC和脑膜脑膨出，并修复由此产生的颅底缺损。
扩大经鼻入路可用于治疗幼儿伴有鼻咽部脑膨出的PCC。该入路适合同时处理这两种情况。扩大经鼻入路避免了可能带来严重并发症的经面部入路，有助于术后早期恢复。
