Chapter 4:
Encephalocele


Encephalocele

Orbital Hypertelorism

Enophthalmos

Exophthalmos

Facial Bipartition

Monobloc Advancement

 

CHAPTERS 

Introduction

Clefts of the Lip and Palate

Ear Reconstruction

Craniosynostosis

Orbital Reconstruction

Treacher Collins Syndrome

Nasal Reconstruction

Orthognathic Surgery

Trauma Reconstruction

Hemifacial Microsomia

Summary

 

Congenital nasal encephaloceles are complex problems that are best treated by the combined efforts of a neurosurgeon and a plastic surgeon. An encephalocele is the herniation of the brain through a congenital or traumatic opening in the cranium. Alterations and distortions of the surrounding facial structures, such as deformities of the naso-orbital skeleton due to an absence or separation of bone in the midline of the face, are complications of encephaloceles due to their position and size. Comprehensive treatment includes resecting the encephalocele, repairing the fibrous covering of the brain, repairing any bony defects, and reconstructing a more normal soft tissue facial appearance. With recent advances in diagnostic and surgical techniques, it is possible to perform a thorough preoperative evaluation and to treat the lesion with definitive one-stage reconstruction at the time of excision.

The nasofrontal encephalocele bone defect is shown with osteotomies for mobilization of the medical orbital walls illustrated. The orbital walls are centrally mobilized and then stabilized and the remaining defects bone grafted.

Nasal Encephalocele

A one week old infant born with large nasal encephalocele Postoperative result at eight months. Postoperative result at five years after definitive one stage reconstruction.

Seven month old boy with large nasal encephalocele

Intraoperative excision of enchephalocele and bony reconstruction.

Postoperative result after definitive 
one stage reconstruction.

NEXT >>

The Tennessee Craniofacial Center, part of the Erlanger Health System, is located in Chattanooga, Tennessee. The Center, led Larry A. Sargent, M.D., specializes in the evaluation and treatment of patients of all ages with craniofacial deformities. Location: 975 East Third Street. Chattanooga, Tennessee 37403
Phone: 423-778-9192 or 800-418-3223 Fax: 423-778-8172
Internet: www.craniofacialcenter.com Copyright ©1997, 2000, Erlanger Health Systems