ALLOGENEIC CARTILAGE USED FOR SKULL BASE PLASTY IN CHILDREN WITH PRIMARY INTRANASAL ENCEPHALOMENINGOCELE ASSOCIATED WITH CEREBROSPINAL-FLUID RHINORRHEA

Three children with primary intranasal encephalomeningocele associated with cerebrospinal fluid rhinorrhea were operated on at the Departmen t of Neurosurgery, Hradec Kralove. In two children, aged 4 and 9.5 yea rs, freeze-dried allogeneic costal cartilage was glued into the skull base defect. This plugging was covered up with deep-frozen allogeneic fascia lata. In the third child, an only 1-year-old boy, after transec tion of the neck of the encephalomeningocele freeze-dried allogeneic d ura mater was glued on extradurally and deep-frozen allogeneic fascia lata applied intradurally. The cerebrospinal fluid rhinorrhea ceased i mmediately after surgery. Spontaneous atrophy of the intranasal portio n of the encephalomeningocele was demonstrated respectively 11, 1, and 7 years postoperatively on computed tomography. To evaluate cartilage healing histologically, the extracted allogeneic cartilage used for o rbital roof plasty after 4 months was examined. The extent of spotty r egressions represented about 7% of the tissue volume. It is stressed t hat, once diagnosed, intranasal encephalomeningocele associated with c erebrospinal fluid rhinorrhea should be operated on for prevention of meningitis as soon as possible.