Sternberg's canal as a cause of encephalocele. Endoscopic endonasal transpterygoid repair
DOI:
https://doi.org/10.59156/rw0vqe98Keywords:
Encephalocele, Endoscopic endonasal surgery, Sternberg canal, Transpterygoid approachAbstract
Background: persistent Sternberg's canal is an uncommon cause of encephalocele at the level of the lateral recess of the sphenoid sinus. Its diagnosis requires a high index of suspicion and confirmation through specific imaging studies. The endonasal endoscopic approach has emerged as a safe and effective alternative for the treatment of these skull base defects.
Objectives: to present the case of a patient diagnosed with intrasphenoidal encephalocele secondary to persistent Sternberg's canal and to describe its resolution via a transpterygoid endonasal endoscopic approach.
Case description: a 53-year-old female patient presented with unilateral rhinorrhea. Magnetic resonance imaging (MRI) and computed tomography (CT) revealed a bony defect in the left lateral recess of the sphenoid sinus, consistent with a persistent Sternberg canal and associated encephalocele.
Surgery: an endoscopic endonasal approach was performed. During the nasal phase, a right nasoseptal flap was created. A left middle turbinectomy and total ethmoidectomy were performed. In the sphenoidal phase, the defect in the left lateral recess was identified. Anatomical landmarks at the base of the pterygoid process were identified. Coagulation and resection of the encephalocele were performed. In the reconstructive phase, a dural patch of collagen matrix was placed within the defect. A bone fragment and nasoseptal flap were added.
Conclusion: the transpterygoid endoscopic approach is a safe and effective alternative for the treatment of encephaloceles secondary to a persistent Sternberg canal, allowing for adequate exposure of the defect, effective multilayer repair, and low morbidity and mortality.
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References
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