Operative technique: Endoscopic transnasal surgery for congenital meningoencephalocele of the anterior skull base.

Congenital meningoencephaloceles of the anterior skull base (ASB) are rare lesions that become evident during childhood and, if not properly diagnosed and treated, can be associated with severe complications. In the past, encephaloceles were treated exclusively with open surgical approaches, which, however, are associated with high complication rates. Recent years have seen the large-scale introduction of transnasal endoscopic approaches to the skull base, and several Authors suggest that endoscopic resection and repair in cases of meningoencephalocele may be the treatment of first choice, being associated with lower complication rates and reduced operative time compared with open procedures. We illustrate step-by-step the transnasal endoscopic treatment of congenital meningoencephalocele and repair of ASB defect by multilayer technique.