Artikel
Midfacial degloving for the removal of transsphenoidal meningocele
Midfacial Degloving für die Entfernung transsphenoidaler Meningozele
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Veröffentlicht: | 7. September 2006 |
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Introduction: The transsphenoidal meningo(encephalo)cele is a congenital dura prolaps in the pterygopalatine fossa through a defect of skull base synostosis resulting in recurrent meningitis or temporal lobe epilepsy.
Method: A transsphenoidal meningocele was found by CT scan on a 32 years old male with history of petit mal epilepsy since childhood and grand mal temporal lobe epilepsy requiring antiepileptic medication for the last 10 years. The meningocele was removed via a midfacial degloving after osteoplastic opening of the anterior and posterior bony wall of the maxillary sinus in order to reach the pterygopalatine fossa. The dura dehiscence was successfully sealed with lyophilized dura, abdominal fat and fibrin glue.
Result: The patient is free of epileptic crisis without any medication.
Conclusion: Midfacial degloving is a simple and reliable approach to the pterygopalatine fossa for treatment of transspenoid meningoceles without visible scars and should be preferred from sophisticated infratemporal or transmandibular approaches with their unacceptable cosmetic result and the risk for the facial nerve.