PMC8407643_01
Preoperative images of the frontoethmoidal encephalocoele
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F1
The mass was bulging between the two orbits and occupying the lowest part of frontal area and superior part of the nasal area [Figure 1].
(a) Axial computed tomography scan image that shows a fronto-ethmoidal encephalocoele with herniation of brain tissue. (b) Sagittal image that shows a bone defect of 13.5 mm in diameter in the frontal bone. (c) Three-dimensional computed tomography scan
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F2
The defect was about 13.5 mm in diameter [Figure 2].
Dissection of the hernial sac from the surrounding structures in the nasoorbital area after a bicoronal approach
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F3
After that a circumferential dissection of the encephalocoele sac was performed, freeing it from the surrounding tissue, until reaching the bone that delimits the malformation including the nasal bone [Figure 3].
After placing a pericranial graft to close the dura, an autologous graft from the parietal bone was used to reconstruct the bone defect. The graft is fixed by absorbable suture
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F4
The graft was fixed by absorbable suture taking support on the crista galli and the frontal bone shell [Figure 4].