Endoscopic repair of transsellar transsphenoidal meningoencephalocele; case report and review of approaches

•We introduce a case of congenital trans-sellar trans-sphenoid meningoencephalocele.•Endoscopic resection of the sac and defect repair have been elucidated.•Hard reconstruction with titanium mesh has been added to the common techniques.•Other few similar cases in the literature have been reviewed.

We present an extremely rare case of transsellar transsphenoidal meningoencephalocele in a 36-year-old woman with pituitary dwarfism complaining of nasal obstruction. Imaging studies showed a bony defect in the sellar floor and sphenoid sinus with huge nasopharyngeal mass and 3rd ventricle involvement. Using endoscopic endonasal approach the sac was partially removed and the defect was reconstructed with fat and fascial graft, and buttressed with titanium mesh and septal flap. Visual field improvement was noticed post-operatively and no complication was encountered during follow-up. So, endoscopic endonasal approach with partial resection of the sac is a safe and effective treatment for this disease