Pediatria pre prax 6/2015

Rare case of nasal obstruction in 13-month old child – case report

Introduction: Nasal meningocele, which is usually congenital, is a rare anomaly resulting from meningeal herniation into the nasal cavities through a bone defect in the skull base. Case report: An 13-months old boy was reffered with respiratory disturbance and nasal obstruction to Children Otorhinolaryngology Clinic in Bratislava. Examination showed a cyst-like grayish swelling filling the right nasal cavity imitates nasal polyp. CT scan showed opacity, of fluid like density, filling the right nasal fossa, in contact with a small bony defect in the right cribriform plate. Magnetic resonance ruled out herniated brain parenchyma and enabled diagnosis of meningocele. The patient was operated at the age of 13 months through a transnasal endoscopic approach. Disscussion: Modern imaging (CT scan and MRI) is of paramount importance in the preoperative evaluation of nasal meningocele. Endoscopic endonasal surgery is currently the treatment of choice. Conclusion: Steady progress in instrumentation, technique and skills will increase the feasibility of skull-base surgery using an endonasal approach in the pediatric population.

Keywords: meningocele, endoscopic endonasal surgery, duraplasty, modern imaging.