Title:Analysis of the Causes and Experience in the Diagnosis and Treatment of
Meningocele Caused by Sternberg’s Canal of the Sphenoid Sinus: Two
Case Reports and a Review of the Literature
Volume: 19
Author(s): Wei You, Zhen-Rong Lin, Yu-Zhe Wang, Wei-Wei Wang, Rui-Sheng Lin, Shu-Qin Qiu and Ai-Shun Guo*
Affiliation:
- Department of Neurosurgery, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of
Fujian Medical University, Zhangzhou 363000, Fujian Province, China
Keywords:
Patent Sternberg’s canal of the sphenoid sinus, meningoencephalocele, cerebrospinal fluid rhinorrhea, diagnoses, pathophysiological mechanisms, causal analysis.
Abstract:
Objective: The present study aimed to improve the diagnosis and treatment outcome of cerebrospinal
fluid (CSF) rhinorrhea caused by patent meningoencephalocele of Sternberg’s canal of the
sphenoid sinus by analyzing the clinical data and imaging features of two rare cases of this disease and
by reviewing the relevant literature for possible etiology, diagnoses, and treatments.
Methods: Together with the relevant literature, we retrospectively studied the clinical and imaging data
of two patients (mother and child) with CSF rhinorrhea caused by patent meningoencephalocele of
Sternberg’s canal of the sphenoid sinus, analyzed their diagnostic and treatment procedures, and proposed
a potential, feasible treatment method.
Results: On the 2nd day after surgery, the expansive sponge and iodoform gauze in the nasal cavity
were removed in both patients, and the lumbar subarachnoid drainage was removed 3 days after the
operation, as no nasal discharge was observed. One week after the operation, head magnetic resonance
imaging (MRI) showed that the abnormal tissue in the sphenoid sinus had disappeared, and no accumulation
of the CSF was observed. Both patients were discharged after 2 weeks. At the time of discharge,
both patients were without nasal drip, fever, headache, and other discomforts, and they had
grade 5 muscle strength in their extremities, with normal muscle tension.
Conclusion: CSF rhinorrhea is usually caused by secondary factors. Spontaneous CSF rhinorrhea
caused by encephalocele of the skull base due to congenital dysplasia of the skull base is very rare and
easily misdiagnosed. The presence of brain tissue or CSF signal in the sphenoid sinus on preoperative
MR images is an important imaging feature of the disease. Conditional cisternography can be used to
further detect CSF leaks. Endoscopic transnasal transsphenoidal repair of CSF leaks combined with
short-term postoperative lumbar subarachnoid drainage is an effective treatment method. According to
previous literature, the possible causes of meningoencephalocele with patent Sternberg’s canal of the
sphenoid sinus include abnormal development of the sphenoid sinus or the craniopharyngeal canal and
bone defects of the skull base. There are no related reports on patent meningoencephalocele caused by
Sternberg’s canal in direct blood relatives, such as mother-son; therefore, the possibility of this disease
having a genetic origin should be considered in future studies on its pathophysiological mechanisms.
