Endoscopic repair of a meningoencephalocele from a medial cribriform lamellar defect
by Vicky S Khattar, Vicky Bachi T

Jaypee’s Video Atlas of Operative Otorhinolaryngology AND Head & Neck Surgery

by Vicky S Khattar, Bachi T Hathiram
About Video

This video demonstrates the repair of a CSF leak emanating from a meningoencephalocele arising from a medial cribriform lamellar defect. It is vital to identify the bony margins of the skullbase defect so as to ensure that the material used for repair adheres firmly to the surrounding bone. The prolapsed meninges as well as brain matter are usually redundant and can be safely cauterized, but must always be done in the presence of, and if possible, with the help of, a neurosurgeon so as not to create any inadvertent complications. If possible, the dual defect should also be sealed separately with fat prior to performing the skullbase repair. It is vital to identify the bony margins of the skullbase defect before the graft is placed. The use of fibrin glue to secure the graft is again a matter of personal preference, but the authors prefer to use the same in all cases.

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