Diagnosis and treatment of congenital sphenoidal meningocele: report of 4 cases

Objective To explore the diagnosis and treatment of transsphenoidal meningocele. Methods The clinical data of 4 patients with transsphenoidal meningocele were analyzed retrospectively. The clinical symptoms and signs included visual decrease with growth retardation, polydipsia and diuresis in 1 patient, visual field defect in 1, cerebrospinal leakage in 1, and mild headache in 1. One patient received operation via nasal columella-nasal septum-sphenoidal approach and 1 via endonasal transsphenoidal approach by endoscope for meningocele repair, and the other 2 patients who had no surgery were closely followed-up. Results Follow-up at 6 and 30 months, improvement of clinical symptoms and no relapse of cerebrospinal leakage were found in 2 patients who underwent surgery, but the other 2 patients without surgery remain unchanged during follow-up of 16 and 20 months. Conclusions The patient with sphenoidal meningocele complicated by cerebrospinal fluid leakage, visual decrease and endocrine disorder can be treated by surgery, while the asymptomatic patient can be followed with no surgery. Endoscopic endonasal surgery is the first choice.