Frontoethmoidal encephaloceles: Reconstruction and refinements

Frontoethmoidal encephaloceles are herniations of the intracranial contents through a defect in the skull at the junction of the frontal and ethmoidal bones. They are generally classified as nasofrontal, nasoethmoidal, and na so-orbital, although there may be some overlap or multiplicity. The records of 35 patients treated for frontoethmoidal encephaloceles were examined. O f these, 12 cases with complete and accurate medical records were evaluated in detail. The successful correction of frontoethmoidal encephaloceles was shown to depend on the following: a detailed understanding of the patholog ical anatomy (such as interorbital hypertelorism rather than true orbital h ypertelorism and the presence of secondary trigonocephaly), careful plannin g of the bone movements to correct these deformities, and attention to deta il regarding the placement of scars, positioning of the medial canthi, and the nasal reconstruction. Avoiding the "long-nose" deformity often seen aft er repair should be a priority. In general, the authors recommend a one-sta ge repair with both a transcranial and external approach.