Transnasal endoscopic repair of congenital defects of the skull base in children.

Objective: To examine imaging findings and methods of endoscopic treatment of congenital skull base defects in children.

Methods: Retrospective study and case series. Methods: Academic tertiary care center. Methods: Four patients (aged 12 and 14 months and 8 and 13 years) were included from 1995 to 1997. Three presented with a nasal glioma, which was recurrent in 1 case. The fourth patient presented with bacterial meningitis due to a spontaneous cerebrospinal fluid leak. Computed tomography and magnetic resonance imaging were used to locate the defect of the skull base. Methods: Transnasal endoscopic resection of the glioma or the meningocele, with immediate repair of the skull base defects using free mucosal flaps and/or pediculized mucosal flaps and/or conchal cartilage together with fibrin glue and nasal packing during a 3-week period.

Results: None of the 4 patients has experienced recurrent cerebrospinal fluid leaks or postoperative meningitis.

Conclusions: The transnasal endoscopic repair of congenital meningoceles is a reliable technique in select pediatric patients. Computed tomography and magnetic resonance imaging provide information that can be used to help the surgical procedure.