Dawit Anteneh Meaza, Gebeyehu Getaw Alamne, Mohammed Salahadin Bedru
Addis Ababa University, Department of Plastic & Reconstructive Surgery, Addis Ababa, Ethiopia.
Addis Ababa University, Department of Plastic & Reconstructive Surgery, Addis Ababa, Ethiopia.
Int J Surg Case Rep. 2024 Oct;123:110254. doi: 10.1016/j.ijscr.2024.110254. Epub 2024 Sep 7.
Encephalocele is a herniation of intracranial contents through a defect in the skull bone. It is a distressing condition that poses significant technical challenge to the managing team, especially in a low-resource setting. In this report we present our experience of managing a case of Frontoethmoidal encephalocele in a 4-month-old infant.
A 4-month-old infant was referred to our center with progressively enlarging mass over the dorsum of the nose. A diagnosis of frontoethmoidal encephalocele and hydrocephalus was established and subsequently, a multidisciplinary team was formulated for the management. An autologous calvarial bone graft was utilized to reconstruct the defect and the clinical outcomes were satisfactory given the circumstances.
Frontoethmoidal encephalocele is infrequently encountered in our experience. It poses a technical challenge for reconstruction. Satisfactory outcomes can be obtained by multidisciplinary team approach. The overall goal of the surgery is the reduction of healthy brain tissue, resection of dysplastic tissue and sac, watertight durable dural closure (either primary or with pericranium flap) and reconstruction of skull defect, using either autologous calvarial bone graft or prosthetic materials (such as titanium mesh, or bone filler).
Despite its rarity and the technical challenges it poses, frontoethmoidal encephalocele can be successfully managed by a multidisciplinary team in a low-resource setting, even in the absence of prosthetic materials.
脑膨出是颅内内容物通过颅骨缺损处的疝出。这是一种令人痛苦的病症，给管理团队带来了重大技术挑战，尤其是在资源匮乏的环境中。在本报告中，我们介绍了我们处理一名4个月大婴儿额筛部脑膨出病例的经验。
一名4个月大的婴儿因鼻背部肿物逐渐增大被转诊至我们中心。确诊为额筛部脑膨出和脑积水，随后组建了一个多学科团队进行管理。使用自体颅骨骨移植来修复缺损，鉴于具体情况，临床结果令人满意。
根据我们的经验，额筛部脑膨出很少见。它给重建带来了技术挑战。通过多学科团队方法可以获得满意的结果。手术的总体目标是减少健康脑组织、切除发育异常的组织和囊、进行防水耐用的硬脑膜闭合（一期或使用帽状腱膜瓣）以及使用自体颅骨骨移植或假体材料（如钛网或骨填充剂）修复颅骨缺损。
尽管额筛部脑膨出罕见且带来技术挑战，但即使在没有假体材料的情况下，多学科团队也可以在资源匮乏的环境中成功处理这种病症。
