Maldivian Boy Treated for Rare Skull Defect at Bannerghatta Hospital

A 10-year-old boy from the Maldives who suffered from recurrent meningitis and a persistent leak of brain fluid for nearly two years has been successfully treated at Apollo Hospitals in Bannerghatta, Bengaluru.

The child had experienced continuous watery discharge from his nose caused by a rare congenital defect in his skull base known as a persistent craniopharyngeal canal. The canal, an opening that typically closes shortly after birth, had remained open and allowed cerebrospinal fluid (CSF) to leak through his nasal passage. The defect was situated behind the adenoid tissue, which had concealed it and made early detection difficult.

Prior to his treatment in Bengaluru, the young patient had undergone two surgeries outside India. However, the leak continued to recur. The previous procedures had also altered the child's nasal anatomy, adding complexity to any further corrective intervention.

To locate the exact source of the leak, doctors in Bengaluru conducted comprehensive diagnostic investigations, including CT scans, MRI scans, CT cisternography, and a nasal endoscopy. Once the precise defect was mapped, surgeons opted for a minimally invasive approach using navigation-assisted endoscopic surgery to access and seal the opening directly through the nose, eliminating the need for an external incision.

The surgical team performed a multilayer repair using tissue grafts, biological glue, and a vascularised nasoseptal flap to securely close the cranial defect.

Dr P Subramanya Rao, neck and skull base surgeon at Apollo Hospitals, Bannerghatta, noted that both diagnosis and treatment were particularly challenging due to the unusual location of the opening and the structural changes left behind by earlier surgeries.

The cerebrospinal fluid leak ceased immediately following the operation. The boy recovered without complications and has since returned to school and resumed his regular activities.