Sphenoidal Meningoencephalocele Secondary to a Persistent Sternberg Canal: A Case Report

TL;DR

A 54-year-old patient had a meningoencephalocele caused by a persistent Sternberg canal, successfully treated with a complex surgical repair.

Contribution

This case report highlights a rare anatomical defect and its successful surgical management.

Findings

A persistent Sternberg canal was identified as the cause of a sphenoidal meningoencephalocele.

A transsphenoidal sphenoidotomy with multilayer reconstruction successfully repaired the defect.

The patient showed favorable outcomes with no recurrence after nine months.

Abstract

The Sternberg canal represents a congenital defect of the lateral wall of the sphenoid sinus, predisposing to spontaneous cerebrospinal fluid (CSF) leakage and the formation of meningoencephaloceles. We report the case of a 54-year-old patient presenting with a four-month history of anterior rhinorrhea in the absence of any other associated symptoms. High-resolution computed tomography and magnetic resonance imaging identified an osteomeningeal defect in the lateral sphenoid sinus wall, associated with a meningoencephalocele. The patient underwent a right transsphenoidal sphenoidotomy with multilayer reconstruction utilizing abdominal fat, conchal cartilage, and biological adhesive. Favorable clinical outcomes were achieved, with no recurrence noted during a nine-month follow-up period. Surgical repair of CSF leaks through the Sternberg canal remains technically demanding, primarily due to the anatomical complexity and restricted accessibility of the lateral sphenoid recess.

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