case_images: PMC11774893_01
case_images: Pre-operative T1 cerebral MRI with contrast showing a left hyperintense frontal parasagittal mass with dural insertion: (A) axial view, (B) sagittal view (C) Postoperative T1 cerebral MRI showing the site of the tumor resection (porencephalic cavity).
case_images: fsurg-11-1436361-g001.jpg
case_images: PMC11774893_01_fsurg-11-1436361-g001.jpg
case_images: F1
case_images: This is a case of a 40-year-old female artist who was resident in Yaounde, with a surgical history of left frontal craniotomy and complete tumor resection performed 4 years ago (Figure 1A-C).
case_images: (A) Coronal view image of a high-resolution CT scan showing the bilateral fronto-ethmoidal osteo-meningeal breach at the anterior cranial base. (B) Axial T2 weighted MRI confirming CSF in the ethmoidal recess. (C) Intraoperative intracranial image showing the fronto-ethmoidal osteo-meningeal breach.
case_images: fsurg-11-1436361-g002.jpg
case_images: PMC11774893_01_fsurg-11-1436361-g002.jpg
case_images: F2
case_images: CT scan revealed a bilateral fronto-ethmoidal osteo-meningeal breach (OMB) (Figure 2A). Cerebral MRI revealed a hyperintense T2 signal in the ethmoidal sinus interrupting the hypo-intensity of the bone (Figure 2B). An open surgery approach was utilized via a bicoronal incision and a bifrontal craniotomy and was tailored to be able to identify the extent of the osteo-meningeal breach (Figure 2C) and perform adequate reconstruction under general anesthesia.
case_images: (A) Reconstruction of the defects with bis-GMA and pericranial flap. A follow-up CT scan showing visible fusion of the bis-GMA with the surrounding bone and complete sealing of the skull base bony defect (B, C).
case_images: fsurg-11-1436361-g003.jpg
case_images: PMC11774893_01_fsurg-11-1436361-g003.jpg
case_images: F3
case_images: The left frontal sinus mucosa was cauterized and blocked with bis-GMA, as was the ethmoidal defect (Figure 3A). A follow-up CT scan revealed the visible fusion of the bis-GMA with the surrounding bone and complete sealing of the skull base bone defect (Figure 3B,C).