Analysis of complications of surgical treatment of acquired and congenital basal encephalocele in children – N.A. Chernikova, E.V. Shelesko, L.A. Satanin, U.V. Strunina, D.N. Zinkevich, A.V. Sakharov

Basal encephalocele is a rare condition manifested by prolapse of altered meninges and brain structures through a bony defect in the skull base. Transcranial, endoscopic transnasal, and combined approaches are used in the basal encephalocele treatment. Often, a comprehensive approach involving neurosurgeons, otorhinolaryngologists, ophthalmologists, maxillofacial surgeons, and anesthesiologists is required. A number of complications may occur during encephalocele surgery, including potentially fatal ones. The purpose of the study: To analyze our experience of surgical treatment of patients with basal encephalocele, to determine the incidence of complications, to identify risk factors and to develop prevention methods.Patients and methods: We conducted a retrospective analysis of a series of 110 patients aged 0 to 18 years with basal encephalocele who underwent surgical treatment at the N.N. Burdenko National Scientific and Practical Center in the period from 2002 to 2022. The mean age of patients was 8±5.5 (0-17) years, 41 (37.3%) female patients and 69 (62.7%) male patients were included. Results: In a series of 110 patients, complications were noted in 6 (5.5%) cases. In 3 (2.7%) cases, patients had inflammatory complications: in 2 (1.8%) cases — meningitis and in 1 (0.9%) – brain abscess. Hemorrhagic complications, namely, subarachnoid hemorrhage (SAH), were noted in 2 (1.8%) patients in the early postoperative period, and 1 (0.9%) patient developed frontal mucocele 5 years after the operation.Conclusion: The potential risk factors for infectious complications are cerebrospinal fluid rhinorrhea, a history of repeated meningitis, severe craniocerebral trauma, and repeated surgical interventions. Hemorrhagic complications may occur due to traumatization of the vessels involve in the hernia. In our study, the incidence of postoperative complications in patients with encephalocele of various etiologies operated via endoscopic and transcranial access was comparable, which proves the effectiveness and safety of the treatment methods for this condition. Keywords: basal encephalocele, skull base, skull base surgery, endoscopic surgeryConflicts of interest. The authors have no conflicts of interest to declare.Funding. There was no funding for this study