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<p>A 14-year-old female presented with progressive right-sided nasal obstruction and intermittent mucoid nasal discharge for six months. Nasal endoscopy revealed a smooth, glistening mass occupying the right nasal cavity. Radiological evaluation with computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated a defect in the right ethmoid sinus with herniation of gliotic brain parenchyma and cerebrospinal fluid into the nasal cavity, consistent with nasofrontal meningoencephalocele. The patient also had biochemical features suggestive of metabolic bone disease, most consistent with vitamin D deficiency–related rickets. She was treated with vitamin D and calcium supplementation. The patient underwent successful endoscopic transnasal excision of the meningoencephalocele with multilayer skull base repair using septal cartilage, fascia lata graft, and fibrin glue. The postoperative period was uneventful, with no cerebrospinal fluid leak or recurrence on follow-up. This case highlights the importance of early diagnosis and demonstrates the effectiveness of endoscopic management in pediatric anterior skull base encephaloceles.</p>

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An Unusual Cause of Unilateral Nasal Obstruction: Nasofrontal Meningoencephalocele in an Adolescent

  • 期刊论文

  • 发表日期：

    2026年5月26日

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  • Lakshana Balakrishnan,
  • Tushar Thotakura,
  • L. Somu

摘要

A 14-year-old female presented with progressive right-sided nasal obstruction and intermittent mucoid nasal discharge for six months. Nasal endoscopy revealed a smooth, glistening mass occupying the right nasal cavity. Radiological evaluation with computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated a defect in the right ethmoid sinus with herniation of gliotic brain parenchyma and cerebrospinal fluid into the nasal cavity, consistent with nasofrontal meningoencephalocele. The patient also had biochemical features suggestive of metabolic bone disease, most consistent with vitamin D deficiency–related rickets. She was treated with vitamin D and calcium supplementation. The patient underwent successful endoscopic transnasal excision of the meningoencephalocele with multilayer skull base repair using septal cartilage, fascia lata graft, and fibrin glue. The postoperative period was uneventful, with no cerebrospinal fluid leak or recurrence on follow-up. This case highlights the importance of early diagnosis and demonstrates the effectiveness of endoscopic management in pediatric anterior skull base encephaloceles.