INTRANASAL ENCEPHALOCELES: Survey of Problem, with Recommendations for Reducing Mortality

Abstract

THE PRINCIPAL purpose of this presentation is to call attention to the diagnostic signs and the proper treatment of intranasal encephalomeningoceles so that they may be recognized and the prevalent excessive mortality greatly reduced. Although the condition is said to occur very rarely, it seems probable that its incidence is greater than has been realized. Undoubtedly many encephalomeningoceles have been erroneously thought to be nasal polyps or tumors. Furthermore, the high mortality which has followed primary intranasal operations must have discouraged any desire to report these cases. Intranasal encephalomeningoceles comprise about 10% of the total groups of congenital hernias of the cranium. They occupy the nasopharyngeal cavity and communicate with intracranial structures through the lamina cribrosa. The hernial sac frequently fills the nasopharyngeal space and causes respiratory obstruction. Cerebrospinal rhinorrhea often occurs spontaneously, and it almost invariably follows whenever surgical removal or a biopsy is carried out through the nose