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Nasal Glioma and Encephalocele: Diagnosis and Management
Author(s) -
Rahbar Reza,
Resto Vicente A.,
Robson Caroline D.,
PerezAtayde Antonio R.,
Goumnerova Liliana C.,
McGill Trevor J.,
Healy Gerald B.
Publication year - 2003
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-200312000-00003
Subject(s) - medicine , encephalocele , craniotomy , surgery , cerebrospinal fluid leak , magnetic resonance imaging , glioma , meningitis , medical record , meningioma , radiology , retrospective cohort study , cerebrospinal fluid , pathology , cancer research
Objective To review the biology of nasal glioma and encephalocele and to present an algorithm for preoperative evaluation and surgical management. Design Retrospective review and analysis. Setting Tertiary care medical center: 1970 to 2002. Patient Sixteen patients with glioma ( n = 10) and encephalocele ( n = 6). Outcome Age at the time of presentation, sex, signs and symptoms, imaging findings, surgical approach, pathology, complications, rate of recurrence, and follow‐up were recorded. Results Ten patients presented with nasal glioma with a mean age of 9 months. All patients underwent surgical excision. No complication was encountered with a mean follow‐up of 3.5 years. Six patients presented with encephaloceles with a mean age of 15.5 months. All patients underwent surgical excision. Complications included cerebrospinal fluid leak ( n = 1) and epiphora ( n = 1). Follow‐up was 1 to 14 years (mean, 4 years). Conclusion Nasal glioma and encephalocele are rare, benign, congenital lesions with a potential for intracranial extension. Evaluation should include a complete rhinologic and neurologic examination. Preoperative imaging with a thin‐cut axial and coronal computed tomography scan and/or multiplanar magnetic resonance imaging is essential. Surgical intervention should be performed soon after diagnosis to alleviate the increased risk of meningitis. A frontal craniotomy approach is recommended if intracranial extension is identified based on preoperative evaluation, followed by an extracranial resection. If there is no evidence of intracranial extension, a conservative extracranial approach is recommended.