Heidekrueger, Paul I. and Thu, Myat and Muehlbauer, Wolfgang and Holm-Muehlbauer, Charlotte and Schucht, Philippe and Anderl, Hans and Schoeneich, Heinrich and Aung, Kyawzwa and Ag, Mg Mg and Myint, Ag Thu Soe and Juran, Sabrina and Aung, Thiha and Ehrl, Denis and Ninkovic, Milomir and Broer, P. Niclas (2017) Safe and sustainable: the extracranial approach toward frontoethmoidal meningoencephalocele repair. JOURNAL OF NEUROSURGERY-PEDIATRICS, 20 (4). pp. 334-340. ISSN 1933-0707, 1933-0715
Full text not available from this repository. (Request a copy)Abstract
OBJECTIVE Although rare, frontoethmoidal meningoencephaloceles continue to pose a challenge to neurosurgeons and plastic reconstructive surgeons. Especially when faced with limited infrastructure and resources, establishing reliable and safe surgical techniques is of paramount importance. The authors present a case series in order to evaluate a previously proposed concise approach for meningoencephalocele repair, with a focus on sustainability of internationally driven surgical efforts. METHODS Between 2001 and 2016, a total of 246 patients with frontoethmoidal meningoencephaloceles were treated using a 1-stage extracranial approach by a single surgeon in the Department of Neurosurgery of the Yangon General Hospital in Yangon, Myanmar, initially assisted by European surgeons. Outcomes and complications were evaluated. RESULTS A total of 246 patients (138 male and 108 female) were treated. Their ages ranged from 75 days to 32 years (median 8 years). The duration of follow-up ranged between 4 weeks and 16 years (median 4 months). Eighteen patients (7.3%) showed signs of increased intracranial pressure postoperatively, and early CSF rhinorrhea was observed in 27 patients (11%), with 5 (2%) of them requiring operative dural repair. In 8 patients, a decompressive lumbar puncture was performed. There were 8 postoperative deaths (3.3%) due to meningitis. In 15 patients (6.1%), recurrent herniation of brain tissue was observed; this herniation led to blindness in 1 case. The remaining patients all showed good to very good aesthetic and functional results. CONCLUSIONS A minimally invasive, purely extracranial approach to frontoethmoidal meningoencephalocele repair may serve well, especially in middle-and low-income countries. This case series points out how the frequently critiqued lack of sustainability in the field of humanitarian surgical missions, as well as the often-cited missing aftercare and dependence on foreign supporters, can be circumvented by meticulous training of local surgeons.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | SURGICAL-CORRECTION; ENCEPHALOMENINGOCELE; ENCEPHALOCELES; MANAGEMENT; CHILDREN; CAMBODIA; CLASSIFICATION; EXPOSURE; SURGERY; CYSTS; frontoethmoidal meningoencephalocele; neural tube defects; humanitarian mission; sustainability; NGO; surgical mission; meningocele; craniofacial |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Chirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 14 Dec 2018 13:19 |
| Last Modified: | 26 Feb 2019 12:49 |
| URI: | https://pred.uni-regensburg.de/id/eprint/2133 |
Actions (login required)
 |
View Item |
