Frontoethmoidal encephalocele

Last revised by Mohamed Saber on 30 Dec 2023

Frontoethmoidal encephaloceles are second only to occipital encephaloceles in terms of frequency, representing approximately 15% of all encephaloceles. They represent meninges or brain tissue herniating through a cranial defect in the anterior cranial fossa and typically result in facial deformity.

Although the classification of encephaloceles is very variable, generally frontoethmoidal encephaloceles are further divided into three subtypes on the basis of the location of defect and path through facial structures into 1,3,5

  • nasoethmoidal (most common)

  • nasofrontal

  • naso-orbital (least common)

The incidence of frontoethmoidal encephaloceles is between 0.8 and 4 per 10,000 births and there is no reported sex predominance. They are, however, particularly common in south-east Asian countries 4

Presentation depends on the location and size of the defect and protrusion. If large the obvious facial deformity will be present with a mass of variable appearance (sessile or pedunculated; normal skin color or pigmentation, soft or firm, may have hypertrichosis) 3

In addition to mass effect encephaloceles may also present with CSF leakage (rhinorrhea) or meningitis.

On clinical examination, the mass will increase in size when intracranial pressures are elevated (Furstenberg sign positive).

Multilayer reconstructive surgery is a method which exhibits excellent results with a high success rate and is advocated as a treatment for such conditions.

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