Supraorbital keyhole approach in the treatment of intranasal meningoencephaloceles

Objective: To explore the effect and significance of endoscopic surgery for intranasal meningoencephaloceles via the supraorbital keyhole approach.

Methods: From January 1999 to December 2001, seven cases of intranasal meningoencephaloceles were treated by mini-invasive endoscopic surgery via supraorbital keyhole approach. The operation was carried out through supraorbital keyhole craniotomy approximately 2.0-2.5 cm in diameter following a skin incision just in the eyebrow. The roughly 3-4 cm skin incision began medial to the supraorbital nerve and ended within the lateral edge of the eyebrow. After the frontal lobe was elevated and the skull base defects exposed, the hernia sac was cut off at bone defect and the lump was resected via nasal cavity. The bone defect were repaired using bone flap, self fat, fascia of rectus abdominis muscle and Ear-Brain Glue.

Results: Seven patients were successfully treated at initial operation without recurrence and cerebrospinal fluid leak during follow-up 6 months to 2 years after surgery.

Conclusions: The supraorbital keyhole approach is a safe approach in the hands of experienced surgeons for the mini-invasive treatment of meningoencephaloceles.