Department of Neurosurgery, Third People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China.
J Craniofac Surg. 2022;33(2):e113-e116. doi: 10.1097/SCS.0000000000007984.
Congenital meningoencephalocele is a herniation of brain and meninges through a skull base defect. It may result not only in neural defects, sensorimotor deficits, neurological morbidities, visual impairment, impaired nasal function, and a potential risk of intracranial infection. Goals of surgery include removal or repositioning of nonfunctional cerebral tissue, closure of the dura, and reconstruction of skeletal and cutaneous structures.
The authors present the case of a 4-months-old infant who was found to have a frontoethmoidal encephalomeningocele that was only discovered after birth, the volume increased gradually. After multiple department discussions, the procedures were planned in 2-staged surgical protocol comprising of the first stage urgently performed by neurosurgeon and craniomaxillofacial surgeon, which aimed at removal or repositioning of nonfunctional cerebral tissue, closure of the dura, and reconstruction of skeletal; then second stage was performed by plastic surgeon to correct craniofacial hard and soft tissue deformities.
The surgical procedures for frontoethmoidal encephalomeningocele are complicated, particularly for the infant. In order to achieve the final surgical purpose, it needs multiple department cooperation to make the surgical plans.
先天性脑脊膜膨出是由于颅骨底部缺陷导致脑和脑膜疝出。它不仅会导致神经缺陷、感觉运动障碍、神经病变、视力损害、鼻腔功能受损，还有潜在的颅内感染风险。手术的目标包括去除或重新定位无功能的脑组织、闭合硬脑膜，以及重建骨骼和皮肤结构。
作者报告了一例 4 个月大的婴儿，其患有额筛脑脊髓膨出，仅在出生后才被发现，体积逐渐增大。经过多部门讨论，制定了两阶段手术方案，第一阶段由神经外科医生和颅面外科医生紧急进行，旨在去除或重新定位无功能的脑组织、闭合硬脑膜，并重建骨骼；然后由整形外科医生进行第二阶段手术，以矫正颅面软硬组织畸形。
额筛脑脊髓膨出的手术程序较为复杂，特别是对于婴儿而言。为了达到最终的手术目的，需要多部门合作制定手术计划。
