Combined endoscopic-microsurgical approach for transsphenoidal (sphenopalatine) encephalocele with an intralesional pituitary gland. Case report.

The treatment of the transsphenoidal sphenopalatine encephalocele in infants alas not been thoroughly described in the literature Pterional and subfrontal transbasal approaches have been reported as the advised treatment for transethmoidal encephalocele, but their feasibility for transsphenoidal encephalocele remains controversial, particularly in neonates The potential harm to vital structures within the herniated tissue rind intraopcrative bleeding have been considered the major cause of poor postoperative results. The authors present the case of a full-terns newborn with a cleft palate and a large transsphenoidal sphenopalatine encephalocele. which filled the nasopharyngeal space and provided MR Imaging evidence of an intralesional pituitary gland. The lesion is unusual and the extracranial intraoral endoscopic approach with all optimal outcome and sparing of the pituitary tissue has never been described in detail in an infant of this age (DOI: 10.3171/2009.4.PEDS0884)