Abstract
We reported a patient with a meningoencephalocele following radical ethmoid surgery. A 44-year-old man was admitted to our hospital because of frontal encephalitis, the cause of which was suggested to be a recurrence of chronic sinusitis in the left ethmoid sinus. CT and axial MRI images showed no evidence of the brain herniation to the ethmoid sinus. He underwent endonasal sinus surgery under local anesthesia. Nasal polypotomy in the left middle nasal meatus was performed, followed by exposure of the brain tissue. On the next day, closure of this defect in the anterior skull base was undergone under general anesthesia using the anterior craniotomy approach by neurosurgeons.
The focus of a convulsion attack after the last ethmoid sinus surgery in this patient's history is considered to be the meningoencephalocele. This fact indicates that the meningoencephalocele of this patient might have occurred postoperatively after radical ethmoid surgery, while almost all of them are congenital. The anterior craniotomy approach is suitable for repair of meningoencephaloceles with central nervous system disorders such as the convulsions of this patient. CT scan and axial MRI images are not useful for diagnosis of meningoencephaloceles and coronal or sagittal MRI images are essential.
