Surgical nuances for the endoscopic endonasal transpterygoid approach to lateral sphenoid sinus encephaloceles

Richard F. Schmidt, Osamah J. Choudhry, Joseph Raviv, Soly Baredes, Roy R. Casiano, Jean Anderson Eloy, James K. Liu

Research output: Contribution to journalArticlepeer-review

43 Scopus citations


Lateral sphenoid encephaloceles of the Sternberg canal are rare entities and usually present with spontaneous CSF rhinorrhea. Traditionally, these were treated via transcranial approaches, which can be challenging given the deep location of these lesions. However, with advancements in endoscopic skull base surgery, including improved surgical exposures, angled endoscopes and instruments, and novel repair techniques, these encephaloceles can be resected and successfully repaired with purely endoscopic endonasal approaches. In this report, the authors review the endoscopic endonasal transpterygoid approach to the lateral recess of the sphenoid sinus for repair of temporal lobe encephaloceles, including an overview of the surgical anatomy from an endoscopic perspective, and describe the technical operative nuances and surgical pearls for these cases. The authors also present 4 new cases of lateral sphenoid recess encephaloceles that were successfully treated using this approach.

Original languageEnglish (US)
Article numberE5
JournalNeurosurgical focus
Issue number6
StatePublished - Jun 2012


  • Cerebrospinal fluid rhinorrhea
  • Endoscopic endonasal transpterygoid approach
  • Endoscopic skull base surgery
  • Lateral sphenoid defect
  • Lateral sphenoid encephalocele
  • Lateral sphenoid recess
  • Nasoseptal flap
  • Sternberg canal

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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