• Gopikrishnan Rajasekar, Prakash Nair, Mathew Abraham, Palak Jaiswal, and Deepti A N Department of Pathology, 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 1; 122: 196-202.

BackgroundA 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.Case DescriptionA 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.ConclusionsThe 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.Copyright © 2018 Elsevier Inc. All rights reserved.

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