{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T08:13:17Z","timestamp":1793261597942,"version":"4.5.0"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Encephaloceles of the lateral sphenoid sinus are rare. Originally believed to be due to defects in a patent lateral craniopharyngeal canal (Sternberg canal), they are now thought to originate more commonly from idiopathic intracranial hypertension, not unlike encephaloceles elsewhere in the skull base. A new classification of these encephaloceles was recently introduced, which divided them in relation to the foramen rotundum. Whether this classification can be applied to a larger cohort from multiple institutions and whether it might be useful in predicting outcome is unknown. Thus, the authors\u2019 goal was to divide a multiinstitutional cohort of patients with lateral sphenoid encephaloceles into four subtypes to determine their incidence and any correlation with surgical outcome.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>A multicenter retrospective review of prospectively acquired databases was carried out across three institutions. Cases were categorized into one of four subtypes (type I, Sternberg canal; type II, medial to rotundum; type III, lateral to rotundum; and type IV, both medial and lateral with rotundum enlargement). Demographic and outcome metrics were collected. Kaplan-Meyer curves were used to determine the rate of recurrence after surgical repair.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>A total of 49 patients (71% female) were included. The average BMI was 32.8. All encephaloceles fell within the classification scheme. Type III was the most common (71.4%), followed by type IV (16.3%), type II (10.2%), and type I (2%). Cases were repaired endonasally, via a transpterygoidal approach. Lumbar drains were placed in 78% of cases. A variety of materials was used for closure, with a nasoseptal flap used in 65%. After a mean follow-up of 47 months, there were 4 (8%) CSF leak recurrences, all in patients with type III or type IV leaks and all within 1 year of the first repair. Two leaks were fixed with ventriculoperitoneal shunt and reoperation, 1 with ventriculoperitoneal shunt only, and 1 with a lumbar drain only. Of 45 patients in whom detailed information was available, there were 12 (26.7%) with postoperative dry eye or facial numbness, with facial numbness occurring in type III or type IV defects only.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Endoscopic endonasal repair of lateral sphenoid wing encephaloceles is highly successful, but repair may lead to dry eye or facial numbness. True Sternberg (type I) leaks were uncommon. Failures and facial numbness occurred only in patients with type III and type IV leaks.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.7.jns23544","type":"journal-article","created":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T03:56:51Z","timestamp":1694836611000},"page":"705-711","source":"Crossref","is-referenced-by-count":12,"title":["Endoscopic endonasal repair of encephaloceles of the lateral sphenoid sinus: multiinstitution confirmation of a new classification"],"prefix":"10.3171","volume":"140","author":[{"given":"Umberto","family":"Tosi","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glen","family":"D\u2019Souza","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology\u2013Head and Neck Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mindy","family":"Rabinowitz","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology\u2013Head and Neck Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Farrell","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology\u2013Head and Neck Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean M.","family":"Parsel","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology\u2013Head and Neck Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay K.","family":"Anand","sequence":"additional","affiliation":[{"name":"Otolaryngology Head and Neck Surgery, NewYork-Presbyterian\/Weill Cornell Medicine, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashutosh","family":"Kacker","sequence":"additional","affiliation":[{"name":"Otolaryngology Head and Neck Surgery, NewYork-Presbyterian\/Weill Cornell Medicine, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abtin","family":"Tabaee","sequence":"additional","affiliation":[{"name":"Otolaryngology Head and Neck Surgery, NewYork-Presbyterian\/Weill Cornell Medicine, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios A.","family":"Zenonos","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl H.","family":"Snyderman","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric W.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Evans","sequence":"additional","affiliation":[{"name":"Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Rosen","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology\u2013Head and Neck Surgery and"},{"name":"Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gurston","family":"Nyquist","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology\u2013Head and Neck Surgery and"},{"name":"Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul A.","family":"Gardner","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore H.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery, and"},{"name":"Otolaryngology Head and Neck Surgery, NewYork-Presbyterian\/Weill Cornell Medicine, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2","key":"b1","series-title":"Am J Rhinol Allergy","first-page":"167","article-title":"Sternberg\u2019s canal: fact or fiction?","volume":"23","author":"Bara\u00f1ano CF","year":"2009","unstructured":"Bara\u00f1ano CF, Cur\u00e9 J, Palmer JN, Woodworth BA. Sternberg\u2019s canal: fact or fiction? Am J Rhinol Allergy. 2009;23(2):167\u2013171."},{"issue":"6","key":"b2","series-title":"Laryngoscope","first-page":"991","article-title":"Comprehensive algorithm for skull base dural lesion and cerebrospinal fluid fistula diagnosis","volume":"114","author":"Meco C","year":"2004","unstructured":"Meco C, Oberascher G. Comprehensive algorithm for skull base dural lesion and cerebrospinal fluid fistula diagnosis. Laryngoscope. 2004;114(6):991\u2013999."},{"issue":"10","key":"b3","series-title":"Acta Neurochir (Wien)","first-page":"2413","article-title":"Low incidence of true Sternberg\u2019s canal defects among lateral sphenoid sinus encephaloceles","volume":"162","author":"Hanz SZ","year":"2020","unstructured":"Hanz SZ, Arko L IV, Schmidt F,  Low incidence of true Sternberg\u2019s canal defects among lateral sphenoid sinus encephaloceles. Acta Neurochir (Wien). 2020;162(10):2413\u20132420."},{"issue":"3","key":"b4","series-title":"AJNR Am J Neuroradiol","first-page":"542","article-title":"Nontraumatic skull base defects with spontaneous CSF rhinorrhea and arachnoid herniation: imaging findings and correlation with endoscopic sinus surgery in 27 patients","volume":"29","author":"Schuknecht B","year":"2008","unstructured":"Schuknecht B, Simmen D, Briner HR, Holzmann D. Nontraumatic skull base defects with spontaneous CSF rhinorrhea and arachnoid herniation: imaging findings and correlation with endoscopic sinus surgery in 27 patients. AJNR Am J Neuroradiol. 2008;29(3):542\u2013549."},{"issue":"2","key":"b5","series-title":"AJNR Am J Neuroradiol","first-page":"337","article-title":"A retrospective analysis of spontaneous sphenoid sinus fistula: MR and CT findings","volume":"21","author":"Shetty PG","year":"2000","unstructured":"Shetty PG, Shroff MM, Fatterpekar GM, Sahani DV, Kirtane MV. A retrospective analysis of spontaneous sphenoid sinus fistula: MR and CT findings. AJNR Am J Neuroradiol. 2000;21(2):337\u2013342."},{"issue":"1","key":"b6","series-title":"J Neurosurg","first-page":"79","article-title":"The critical importance of a vascularized flap in preventing recurrence after endoscopic repair of spontaneous cerebrospinal fluid leaks and meningoencephaloceles","volume":"137","author":"Michael AP","year":"2022","unstructured":"Michael AP, Elbuluk O, Tsiouris AJ,  The critical importance of a vascularized flap in preventing recurrence after endoscopic repair of spontaneous cerebrospinal fluid leaks and meningoencephaloceles. J Neurosurg. 2022;137(1):79\u201386."},{"key":"b7","series-title":"J Neuroophthalmol. Published online February","article-title":"Temporal lobe encephalocele in a patient with suspected IIH: a case report","volume":"25,","author":"Peralta EA","year":"2022","unstructured":"Peralta EA, Swiston CJ, Wiggins RH, Warner JEA, Vegunta S. Temporal lobe encephalocele in a patient with suspected IIH: a case report. J Neuroophthalmol. Published online February 25,2022. doi:10.1097\/WNO.0000000000001484"},{"issue":"5","key":"b8","series-title":"J Neurosurg","first-page":"1720","article-title":"Nonrandom spatial clustering of spontaneous anterior fossa cerebrospinal fluid fistulas and predilection for the posterior cribriform plate","volume":"126","author":"Murray RD","year":"2017","unstructured":"Murray RD, Friedlander R, Hanz S, Singh H, Anand VK, Schwartz TH. Nonrandom spatial clustering of spontaneous anterior fossa cerebrospinal fluid fistulas and predilection for the posterior cribriform plate. J Neurosurg. 2017;126(5):1720\u20131724."},{"issue":"6)(suppl","key":"b9","series-title":"World Neurosurg","first-page":"S86","article-title":"The endoscopic endonasal approach to repair of iatrogenic and noniatrogenic cerebrospinal fluid leaks and encephaloceles of the anterior cranial fossa","volume":"82","author":"Bedrosian JC","year":"2014","unstructured":"Bedrosian JC, Anand VK, Schwartz TH. The endoscopic endonasal approach to repair of iatrogenic and noniatrogenic cerebrospinal fluid leaks and encephaloceles of the anterior cranial fossa. World Neurosurg. 2014;82(6)(suppl):S86\u2013S94."},{"issue":"5","key":"b10","series-title":"Neurosurgery","first-page":"991","article-title":"Endoscopic cranial base surgery: classification of operative approaches","volume":"62","author":"Schwartz TH","year":"2008","unstructured":"Schwartz TH, Fraser JF, Brown S, Tabaee A, Kacker A, Anand VK. Endoscopic cranial base surgery: classification of operative approaches. Neurosurgery. 2008;62(5):991\u20131005."},{"issue":"5","key":"b11","series-title":"J Neurosurg","first-page":"1070","article-title":"Endoscopic management of spontaneous meningoencephalocele of the lateral sphenoid sinus","volume":"112","author":"Tabaee A","year":"2010","unstructured":"Tabaee A, Anand VK, Cappabianca P, Stamm A, Esposito F, Schwartz TH. Endoscopic management of spontaneous meningoencephalocele of the lateral sphenoid sinus. J Neurosurg. 2010;112(5):1070\u20131077."},{"issue":"1","key":"b12","series-title":"Laryngoscope","first-page":"70","article-title":"Spontaneous cerebrospinal fluid leak repair: a five-year prospective evaluation","volume":"124","author":"Chaaban MR","year":"2014","unstructured":"Chaaban MR, Illing E, Riley KO, Woodworth BA. Spontaneous cerebrospinal fluid leak repair: a five-year prospective evaluation. Laryngoscope. 2014;124(1):70\u201375."},{"issue":"9","key":"b13","series-title":"Laryngoscope","first-page":"2011","article-title":"Intervention for elevated intracranial pressure improves success rate after repair of spontaneous cerebrospinal fluid leaks","volume":"127","author":"Teachey W","year":"2017","unstructured":"Teachey W, Grayson J, Cho DY, Riley KO, Woodworth BA. Intervention for elevated intracranial pressure improves success rate after repair of spontaneous cerebrospinal fluid leaks. Laryngoscope. 2017;127(9):2011\u20132016."},{"issue":"4","key":"b14","series-title":"Rhinology","first-page":"376","article-title":"The fate of the bone graft in cerebrospinal fluid rhinorrhea endoscopic repair for idiopathic intracranial hypertension: a retrospective case series analysis","volume":"55","author":"Workman AD","year":"2017","unstructured":"Workman AD, Carey RM, Parasher AK,  The fate of the bone graft in cerebrospinal fluid rhinorrhea endoscopic repair for idiopathic intracranial hypertension: a retrospective case series analysis. Rhinology. 2017;55(4):376\u2013381."},{"issue":"1","key":"b15","series-title":"Interv Neuroradiol","first-page":"129","article-title":"Venous sinus stenting as a treatment approach in patients with idiopathic intracranial hypertension and encephaloceles","volume":"27","author":"Drocton GT","year":"2021","unstructured":"Drocton GT, Copelan A, Eisenmenger L,  Venous sinus stenting as a treatment approach in patients with idiopathic intracranial hypertension and encephaloceles. Interv Neuroradiol. 2021;27(1):129\u2013136."},{"key":"b16","series-title":"World Neurosurg","first-page":"103","article-title":"Venous sinus stenting in the management of patients with intracranial hypertension manifesting with skull base cerebrospinal fluid leaks","volume":"106","author":"Iyer RR","year":"2017","unstructured":"Iyer RR, Solomon D, Moghekar A,  Venous sinus stenting in the management of patients with intracranial hypertension manifesting with skull base cerebrospinal fluid leaks. World Neurosurg. 2017;106:103\u2013112."},{"issue":"4","key":"b17","series-title":"J Neuroophthalmol","first-page":"487","article-title":"Do most patients with a spontaneous cerebrospinal fluid leak have idiopathic intracranial hypertension?","volume":"39","author":"Bidot S","year":"2019","unstructured":"Bidot S, Levy JM, Saindane AM, Oyesiku NM, Newman NJ, Biousse V. Do most patients with a spontaneous cerebrospinal fluid leak have idiopathic intracranial hypertension? J Neuroophthalmol. 2019;39(4):487\u2013495."},{"issue":"2","key":"b18","series-title":"Interv Neuroradiol","first-page":"257","article-title":"Management of idiopathic intracranial hypertension in children utilizing venous sinus stenting","volume":"27","author":"Schwarz J","year":"2021","unstructured":"Schwarz J, Al Balushi A, Sundararajan S,  Management of idiopathic intracranial hypertension in children utilizing venous sinus stenting. Interv Neuroradiol. 2021;27(2):257\u2013265."},{"issue":"2","key":"b19","series-title":"J Neuroradiol","first-page":"148","article-title":"Dural venous sinus stenting for idiopathic intracranial hypertension: An updated review","volume":"46","author":"Leishangthem L","year":"2019","unstructured":"Leishangthem L, SirDeshpande P, Dua D, Satti SR. Dural venous sinus stenting for idiopathic intracranial hypertension: An updated review. J Neuroradiol. 2019;46(2):148\u2013154."},{"issue":"5","key":"b20","series-title":"J Neurosurg","first-page":"961","article-title":"Endoscopic endonasal repair of anterior skull base non-traumatic cerebrospinal fluid leaks, meningoceles, and encephaloceles","volume":"113","author":"Nyquist GG","year":"2010","unstructured":"Nyquist GG, Anand VK, Mehra S, Kacker A, Schwartz TH. Endoscopic endonasal repair of anterior skull base non-traumatic cerebrospinal fluid leaks, meningoceles, and encephaloceles. J Neurosurg. 2010;113(5):961\u2013966."},{"issue":"2","key":"b21","series-title":"Laryngoscope","first-page":"345","article-title":"Endonasal endoscopic repair of Sternberg\u2019s canal cerebrospinal fluid leaks","volume":"117","author":"Castelnuovo P","year":"2007","unstructured":"Castelnuovo P, Dallan I, Pistochini A, Battaglia P, Locatelli D, Bignami M. Endonasal endoscopic repair of Sternberg\u2019s canal cerebrospinal fluid leaks. Laryngoscope. 2007;117(2):345\u2013349."},{"key":"b22","series-title":"BMC Ear Nose Throat Disord","first-page":"11","article-title":"Endoscopic repair of lateral sphenoid encephaloceles: a case series","volume":"17","author":"Gore MR","year":"2017","unstructured":"Gore MR. Endoscopic repair of lateral sphenoid encephaloceles: a case series. BMC Ear Nose Throat Disord. 2017;17:11."},{"issue":"2","key":"b23","series-title":"Indian J Otolaryngol Head Neck Surg","first-page":"188","article-title":"Endoscopic repair of lateral sphenoid recess cerebrospinal fluid leaks","volume":"64","author":"Kirtane MV","year":"2012","unstructured":"Kirtane MV, Lall A, Chavan K, Satwalekar D. Endoscopic repair of lateral sphenoid recess cerebrospinal fluid leaks. Indian J Otolaryngol Head Neck Surg. 2012;64(2):188\u2013192."},{"issue":"5","key":"b24","series-title":"Oper Neurosurg (Hagerstown)","first-page":"600","article-title":"Lateral transorbital versus endonasal transpterygoid approach to the lateral recess of the sphenoid sinus\u2014a comparative anatomic study","volume":"16","author":"Alves-Belo JT","year":"2019","unstructured":"Alves-Belo JT, Mangussi-Gomes J, Truong HQ,  Lateral transorbital versus endonasal transpterygoid approach to the lateral recess of the sphenoid sinus\u2014a comparative anatomic study. 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