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Neurosurgical management of anterior meningo-encephaloceles about 60 cases.

Rifi L, Barkat A, El Khamlichi A, Boulaadas M, El Ouahabi A - Pan Afr Med J (2015)

Bottom Line: MEA are surgically approached in various ways, mainly on the basis of its location and type, by cranio-facial approach in one-step, or in two stages by intracranial approach followed by facial approach, only by cranial approach or facial approach.The mean age at time of surgery was 14 months (20 days to 18 years) with slight men predominance (28 females/32 males).After mean follow up for 80 months (1 year to 19 years) theses techniques permitted a good cosmetics results in 42 cases, average cosmetics results in 8 cases, poor results in 5 cases and worse cosmetics results in 4 cases, The AME are rare conditions we used the multiples approach first intracranial approach followed by facial approach, but after 1998 we used one-step correction by combined approach, only cranial approach when needed or facial correction.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, National Centre of Rehabilitation and Neurosciences, Rabat, Morocco ; Mohamed V University Rabat, Morocco.

ABSTRACT
Anterior meningo-encephaloceles (AME) are congenital malformations characterized by herniation of brain tissue and meninges through a defect in the cranium, in frontal, orbital, nasal and ethmoidal regions. The management of this complex congenital malformation is controversial according to whether use, an intracranial, extra-cranial or combined approach. This is the first largest series published in Africa, in which we present our experience in the operative management of AME; we share our recommendation in technical consideration for surgical approach with review of the literature. All patients beneficed of neuro-radiological investigations including Plan X rays, Spiral Three dimensional CT scan and MRI. Ophthalmologic and maxillo-facial evaluations were done in all the cases. MEA are surgically approached in various ways, mainly on the basis of its location and type, by cranio-facial approach in one-step, or in two stages by intracranial approach followed by facial approach, only by cranial approach or facial approach. The surgical results were evaluated in the follow up on the basis of disappearance of cranio-facial tumefaction with correction of hypertelorism. 60 children with AME were treated in our department between January 1992 and December 2012. The mean age at time of surgery was 14 months (20 days to 18 years) with slight men predominance (28 females/32 males). Cranio-facial team operated 21 patients, 16 were operated in two stages by intracranial approach followed by facial approach, 20 cases beneficed the neurosurgical approach and three only the facial approach Some post operative complications were observed: 2 cases of post operative hydrocephalus underwent shunt; CSF fistulas in three cases cured by spinal drainage, one death due to per operative hypothermia, 3 cases of recurrence how needed second surgery. After mean follow up for 80 months (1 year to 19 years) theses techniques permitted a good cosmetics results in 42 cases, average cosmetics results in 8 cases, poor results in 5 cases and worse cosmetics results in 4 cases, The AME are rare conditions we used the multiples approach first intracranial approach followed by facial approach, but after 1998 we used one-step correction by combined approach, only cranial approach when needed or facial correction.

No MeSH data available.


Related in: MedlinePlus

The same girl three years later
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Figure 0005: The same girl three years later

Mentions: First case: 50 days girl who presented a fronto - nasal meningocele has been operated by neurosurgeons and the maxillofacial procedure simultaneously (Figure 4) shows the preoperative appearance and Figure 5 shows the appearance of the child 3 years later with a good result Second case: the 9 months old boy with fronto-nasal meningo-encephalocele (Figure 6). Operated first with cranial approach, and facial approach 6 years later. The same boy after facial surgery (Figure 7) with average cosmetics results.


Neurosurgical management of anterior meningo-encephaloceles about 60 cases.

Rifi L, Barkat A, El Khamlichi A, Boulaadas M, El Ouahabi A - Pan Afr Med J (2015)

The same girl three years later
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4587085&req=5

Figure 0005: The same girl three years later
Mentions: First case: 50 days girl who presented a fronto - nasal meningocele has been operated by neurosurgeons and the maxillofacial procedure simultaneously (Figure 4) shows the preoperative appearance and Figure 5 shows the appearance of the child 3 years later with a good result Second case: the 9 months old boy with fronto-nasal meningo-encephalocele (Figure 6). Operated first with cranial approach, and facial approach 6 years later. The same boy after facial surgery (Figure 7) with average cosmetics results.

Bottom Line: MEA are surgically approached in various ways, mainly on the basis of its location and type, by cranio-facial approach in one-step, or in two stages by intracranial approach followed by facial approach, only by cranial approach or facial approach.The mean age at time of surgery was 14 months (20 days to 18 years) with slight men predominance (28 females/32 males).After mean follow up for 80 months (1 year to 19 years) theses techniques permitted a good cosmetics results in 42 cases, average cosmetics results in 8 cases, poor results in 5 cases and worse cosmetics results in 4 cases, The AME are rare conditions we used the multiples approach first intracranial approach followed by facial approach, but after 1998 we used one-step correction by combined approach, only cranial approach when needed or facial correction.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, National Centre of Rehabilitation and Neurosciences, Rabat, Morocco ; Mohamed V University Rabat, Morocco.

ABSTRACT
Anterior meningo-encephaloceles (AME) are congenital malformations characterized by herniation of brain tissue and meninges through a defect in the cranium, in frontal, orbital, nasal and ethmoidal regions. The management of this complex congenital malformation is controversial according to whether use, an intracranial, extra-cranial or combined approach. This is the first largest series published in Africa, in which we present our experience in the operative management of AME; we share our recommendation in technical consideration for surgical approach with review of the literature. All patients beneficed of neuro-radiological investigations including Plan X rays, Spiral Three dimensional CT scan and MRI. Ophthalmologic and maxillo-facial evaluations were done in all the cases. MEA are surgically approached in various ways, mainly on the basis of its location and type, by cranio-facial approach in one-step, or in two stages by intracranial approach followed by facial approach, only by cranial approach or facial approach. The surgical results were evaluated in the follow up on the basis of disappearance of cranio-facial tumefaction with correction of hypertelorism. 60 children with AME were treated in our department between January 1992 and December 2012. The mean age at time of surgery was 14 months (20 days to 18 years) with slight men predominance (28 females/32 males). Cranio-facial team operated 21 patients, 16 were operated in two stages by intracranial approach followed by facial approach, 20 cases beneficed the neurosurgical approach and three only the facial approach Some post operative complications were observed: 2 cases of post operative hydrocephalus underwent shunt; CSF fistulas in three cases cured by spinal drainage, one death due to per operative hypothermia, 3 cases of recurrence how needed second surgery. After mean follow up for 80 months (1 year to 19 years) theses techniques permitted a good cosmetics results in 42 cases, average cosmetics results in 8 cases, poor results in 5 cases and worse cosmetics results in 4 cases, The AME are rare conditions we used the multiples approach first intracranial approach followed by facial approach, but after 1998 we used one-step correction by combined approach, only cranial approach when needed or facial correction.

No MeSH data available.


Related in: MedlinePlus