Planum sphenoidale meningoencephalocele

Case contributed by Dr Varun Babu

Presentation

Chronic sinusitis, history of nasal and sinus surgery (details unavailable)

Patient Data

Age: 40 years
Gender: Male

CT paranasal sinuses

Modality: CT
  • central nasal septal defect
  • partial right middle turbinectomy
  • polypoidal mucosal thickening seen in right maxillary sinus ostium along with circumferential sinus mucosal thickening
  • air fluid levels seen in bilateral ethmoid air cells along with mild mucosal thickening in right frontonasal drainage
  • bony defect of the right posterior planum sphenoidale with well defined sac and convex inferior margins projecting into the sinus cavity

MRI paranasal sinuses

Modality: MRI
  • posterior right gyrus rectus encephalomalacia with herniation of part of gyrus through the defect with an intact meningeal lined sac of CSF protruding into the sinus cavity. 

Case Discussion

Planum sphenoidale defect with sinus communication of neuroparenchyma can occur in sinus surgeries. In particular, they may occur during middle turbinectomy and uncinectomy depending on the anatomic configuration of the latter. This may result in CSF rhinorrhea, and should be brought to the attention of the ENT surgeon, for urgent planum sphenoidale repair, as life threatening cranial spread of infection can occur. 

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Case Information

rID: 47241
Case created: 6th Aug 2016
Last edited: 7th Aug 2016
Inclusion in quiz mode: Included

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