Document Detail


Tailor-made orbitocranioplasty for a sphenorbital encephalocele presenting as pulsatile exophthalmos. Case report.
MedLine Citation:
PMID:  17330538     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Basal encephaloceles account for only 1.5% of all encephaloceles. Within this group, the sphenorbital type is quite rare but causes herniation of the brain into the orbit, leading to pulsatile exophthalmos and disturbance of visual acuity. The authors present a case of successful orbitocranioplasty for a sphenorbital encephalocele in which they used a skull model in preparation for the operation. A plaster skull model was made from 3D computed tomography (CT) data obtained in a 6-year-old girl with a sphenorbital encephalocele to determine the appropriate size and shape of an implant for repair of the malformation. A hydroxyapatite ceramic implant with high affinity to autologous bone was designed to cover the defect and simultaneously to enlarge the volume of the orbit as well as allow rigid fixation. Postoperative 3D CT scanning demonstrated good placement of the implant, and the patient's pulsatile exophthalmos diminished immediately. The patient's postoperative condition has been good, and she has exhibited no neurological deficit or deformity of the skull around the cranioplasty 30 months after the operation. A skull model using 3D CT data is useful for determining the most appropriate strategy for reconstruction. Hydroxyapatite ceramic implants have high affinity to autologous bone and thus are suitable for children. In cases such as the present one, however, the patient should be observed carefully to ensure that there is not an imbalance between the implant and the still growing autologous skull.
Authors:
Hiroyuki Katano; Noritaka Aihara; Yotaro Takeuchi; Miho Nozaki; Kazuo Yamada
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  106     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-03-02     Completed Date:  2007-07-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  126-30     Citation Subset:  AIM; IM    
Affiliation:
Departments of Neurosurgery and Restorative Neuroscience, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. katano@med.nagoya-cu.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Bone Substitutes
Ceramics
Child
Computer-Aided Design
Diagnosis, Differential
Durapatite
Encephalocele / diagnosis,  surgery*
Exophthalmos / diagnosis*
Female
Follow-Up Studies
Humans
Imaging, Three-Dimensional / methods
Models, Anatomic
Orbit / abnormalities,  surgery*
Patient Care Planning
Prosthesis Design
Reconstructive Surgical Procedures / methods*
Sphenoid Bone / abnormalities,  surgery*
Tomography, X-Ray Computed / methods
Chemical
Reg. No./Substance:
0/Bone Substitutes; 0/Ceramics; 1306-06-5/Durapatite

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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