Dual- and Single-Task Training in Older Adults With Age-Related Hearing Loss: A Randomized Controlled Study.

We aimed to investigate the effects of dual- and single-task training in older adults with age-related hearing loss. Intervention groups included single-, dual-task training, and control groups. The dual- and single-task trainings were held 2 days a week for 40 min for a total of 10 sessions for 5 weeks. We evaluated physical, cognitive, and auditory functions, quality-of-life, balance, concerns about falling, independence in activities of daily living, and dual-task performance. A total of 42 patients fully participated in this study. Statistically significant differences were observed in chair stand, chair sit-and-reach, global cognitive function, and delayed recall between the intervention groups and control group (p < .05). There was no statistically significant difference in quality-of-life, balance, falling concerns, independence in activities of daily living, and dual-task performance between all groups (p > .05). In conclusion, single- and dual-task training had a positive effect on physical and cognitive functioning in older adults with age-related hearing loss.

The Effect of Intracochlear and Intratympanic Dexamethasone on Cochlear Implant Impedance.

Objective: This study investigated the impact of different local corticosteroid applications on impedance measurements in patients with cochlear implants. Methods: The study was designed as a controlled, randomized, and prospective study in which 34 consecutive patients who had undergone cochlear implant surgery were divided into three groups. The first group received intracochlear dexamethasone, in the second group the middle ear cavity was filled with dexamethasone, and the third group did not receive dexamethasone. Intraoperative, postoperative 1st week, 1st month, 3rd month, 6th-month neural response telemetry, and impedances were measured. The measurements were compared by electrode groups representing the different regions of cochlea like basal (1-7), middle (8-13), and apical (14-22) regions. Results: The intergroup analysis showed no statistically significant differences in impedance measurements of the basal, middle, and apical regions (p>0.05). However, the impedances were lower in the two dexamethasone groups, especially in the basal and middle parts. Sixth month impedances were also lower in the dexamethasone groups. There was apparent stability in the impedance of the basal region with the intracochlear application during the first week. Conclusion: Local dexamethasone applications had a potentially positive impact on the impedance of the basal and middle regions. Patients had lower impedances than the control group during follow-up and at the endpoint. The increase in the apical region may indicate that dexamethasone was not reaching the apical zone in local applications.

Transcanal Endoscopic Management of Middle Ear Paragangliomas.

OBJECTIVE: To evaluate the clinical and audiological outcomes of transcanal endoscopic resection of middle ear paragangliomas. STUDY DESIGN: Retrospective multicenter study. SETTING: Tertiary referral center and private otology clinic. PATIENTS: Patients who underwent transcanal endoscopic surgery between January 2015 and September 2020. INTERVENTIONS: Transcanal endocope-assisted resection of middle ear paragangliomas. MAIN OUTCOME MEASURES: Demographic data. RESULTS: Twenty-three patients (2 men, 21 women) with a mean (standard deviation [SD]) age of 50.5 (11.8) years and stage 1 or 2 disease were included in the study. The mean follow-up time was 2.7 years (range, 1-5 yr). Preoperatively, the mean (SD) air-conduction threshold was 33.8 (17.9) dB, and the mean (SD) air-bone gap was 13.1 (13.9) dB. Postoperatively, the mean (SD) air-conduction threshold was 25.7 (10.2) dB, the mean (SD) air-bone gap was 6.3 (6.1) dB. The mean (SD) hospital stay was 27.7 (9.9) hours. No tumor regrowth was detected on magnetic resonance imaging during postoperative follow-up. CONCLUSIONS: Endoscopic transcanal tumor resection is effective and feasible in the treatment of stage 1 and 2 tumors and is associated with short operative time, low risk of perioperative and postoperative complications, and rapid discharge.

Subjective Visual Vertical test with the 3D virtual reality system: effective factors and cybersickness.

BACKGROUND: 3D Virtual Reality (VR) offers new opportunities in vestibular science. It also presents new challenges and problems. AIMS/OBJECTIVES: The study aimed to evaluate the effective factors in the 3D VR Subjective Visual Vertical (SVV) test and the impact of cybersickness on the test results. MATERIAL AND METHODS: The effect of the foam surface, head position in the yaw axis, moving background, and arm position holding the controller was tested. Cybersickness was evaluated using the Simulator Sickness Questionnaire (SSQ). RESULTS: The head position and controller holding style significantly affected the results. The foam surface and the moving background did not have a significant effect. Although 61.4% of the patients fell into the bad category according to the symptoms of the SSQ score, cybersickness did not significantly affect the SVV results. CONCLUSIONS AND SIGNIFICANCE: In 3D VR SVV, additional factors should be considered: the headset's weight, head position, and how we hold the controller. The A-effect emerged when the head was 45 degrees turned on the yaw axis. A significant shift was detected in the test, with the arm holding the controller at 90 degrees. Most subjects felt cybersickness at a considerable level. Cybersickness should always be taken into account in VR when planning new applications.

Wideband Tympanometry and Absorbance for Diagnosing Middle Ear Fluids in Otitis Media with Effusion.

BACKGROUND: Surgical tympanostomy tube insertion is a standard procedure in Otitis media with effusion after proper follow-up. During the surgery, the presence of serous or mucoid fluids, atelectatic tympanic membrane, or empty ear may be observed, despite all patients having the same diagnosis. A better method based on a non-invasive approach can help avoid unnecessary surgery. This study aimed to compare surgically confirmed otitis media with effusion with wideband tympanometry and absorbance tests. METHODS: A total of 122 children diagnosed with otitis media with effusion were included. Eighty healthy children were included as controls. Ears were divided into 4 groups: serous, mucoid, atelectasis, and empty. Resonance frequency, 226 Hz and 1000 Hz compliance, wideband peak pressure, and absorbance data were used for comparison. RESULTS: The most practical tests were the average of 500, 1000, and 2000 Hz absorbance according to positive likelihood ratio (4.8) and model 2 according to negative likelihood ratio (0.11). It was better than the standard 226 Hz and 1000 Hz compliance tests. Although some statistically significant parameters were observed between serous fluid and empty ear, they were not sufficiently impactful for a differential diagnosis. No parameter could help us differentiate between serous and mucous fluids. CONCLUSION: According to negative likelihood ratio (0.11), a person with normal middle ear is 9 times more likely to have negative test with the use of resonance frequency, wideband tympanometry, and average absorbance together. To differentiate serous fluid from the empty ear, using only 226 Hz or 1000 Hz compliance for surgical indication can potentially cause wrong decisions according to negative likelihood ratios.

Effectiveness of conventional versus virtual reality-based vestibular rehabilitation exercises in elderly patients with dizziness: a randomized controlled study with 6-month follow-up.

OBJECTIVES: To investigate the effect of vestibular rehabilitation exercises supported with virtual reality containing real-life environments on dizziness, static and dynamic balance, functional mobility, fear of falling, anxiety, and depression in elderly patients with dizziness. METHODS: In this prospective randomized controlled study, 32-patients aged 65-years and older who applied to the otorhinolaryngology clinic with dizziness complaint randomly assigned to 2 groups. In Group 1 (n=16), vestibular rehabilitation program, supported with virtual reality, and in Group 2 (n=16), conventional vestibular rehabilitation program was applied 30-min a day, 5 sessions per week, 15 sessions in total for 3 weeks. Subjects were evaluated with The Vertigo Symptom Scale (VSS), Dizziness Handicap Inventory (DHI), Berg Balance Test (BBT) and Timed Up & Go Test (TUG), Falls Efficacy Scale-International (FES-I), Postural Stability Test (PST), Geriatric Depression Scale (GDS), Hamilton Anxiety Scale (HAS) at baseline, at the end of the treatment and 6-months after the treatment. RESULTS: Statistically significant improvements were seen in the DHI emotional subscale and TUG in Group 1 compared to Group 2 at the end of the treatment in elderly with dizziness (p<0.05). Also, there were significant improvements in the VSS, all DHI subgroups, and total scores, BBT, HAS in Group 1 compared to Group 2 at the 6-months after the treatment (p<0.05). CONCLUSION: The application of vestibular rehabilitation in a virtual reality environment can lead to additional improvements especially in dizziness symptoms, disability, balance, and mobility in the elderly with chronic dizziness.

Effectiveness of whole-body vibration or biofeedback postural training as an add-on to vestibular exercises rehabilitation therapy in chronic unilateral vestibular weakness: A randomized controlled study.

BACKGROUND: The efforts to achieve better functional results in vestibular rehabilitation have been continued by using different visual and somatosensory stimuli for a long time. Whole-body vibration (WBV) is a mechanical vertical stimulation that provides high frequency vibration stimulus to the proprioceptive receptors. Biofeedback provides continuous information to the subject regarding postural changes. These techniques may aid to improve vestibular rehabilitation. OBJECTIVE: We aimed to investigate the effect of adding WBV or biofeedback postural training (BPT) to standard rehabilitation exercises in patients with chronic unilateral vestibular weakness. METHODS: Ninety patients were randomized into three groups. Group 1 had WBV and Group 2 BPT in addition to the standard rehabilitation exercises. Group 3 only carried out the home-based exercises and served as the control. Outcome measures such as static posturography, Berg Balance Scale, Timed Up-and-Go test, Visual Analog Scale, and Dizziness Handicap Inventory (DHI) were used for comparison. RESULTS: Statistically significant gains were achieved in all groups with all parameters at the end of treatment when compared to baseline (p < 0.05). The patients in Group 1 (WBV), however, were significantly better than those in Groups 2 and 3 at the static posturographic stability score, Berg Balance Scale, and DHI (p < 0.05). CONCLUSION: Adding WBV to a rehabilitation program may be an effective strategy to improve postural stability and achieve better physical, functional and emotional outcomes.

Salivary gland tumors: A 15-year experience of a university hospital in Turkey.

OBJECTIVE: To determine the demographic characteristics of benign and malignant salivary gland tumors in our department in the last 15 years. METHODS: In this study, the files of the patients who underwent salivary gland surgery between 2004 and 2019 in our department were analyzed retrospectively. A total of 366 patients whose diagnoses of salivary gland tumor histopathologically confirmed were included in this study. The demographic data of the patients and tumor localizations were recorded, and their relationships with histopathological results were examined. RESULTS: Of the 366 tumors, 292 (80%) of them was originated from the parotid gland, 52 (14%) from the submandibular gland, and 22 (6%) from the minor salivary gland. The male: female ratio was found as 1.2:1, and the mean age of the patients was 50.37 years. A total of 259 (70.8%) tumors were benign, and 107 (29.2%) were malignant. The most frequent benign tumor was pleomorphic adenoma, with 121 cases (46.7%). While pleomorphic adenomas constituted the majority of the benign tumors of the submandibular gland and minor salivary glands, Warthin tumor was detected more than pleomorphic adenoma in the parotid gland. The most common malignant tumor was mucoepidermoid carcinoma, with 26 cases (24.3%). CONCLUSION: The distribution of the salivary gland tumors detected in our department was found to be substantially similar to other worldwide series. Unlike the literature, we concluded that salivary gland tumors were seen slightly more in males, minor salivary gland tumors were relatively rare and Warthin tumors were more frequently detected in our region.

Validation of the Turkish Version of the Facial Nerve Grading System 2.0.

OBJECTIVE: We aimed to adapt the Facial Nerve Grading System 2.0 (FNGS 2.0) to Turkish and to investigate the validity and the reliability of the Turkish version. METHODS: The original FNGS 2.0 was translated into Turkish and validated by international standards. Six Turkish physicians, three specialists and three residents, independently rated the videos, two times each, of 40 adult facial palsy patients. Inter-rater and intra-rater reliability were assessed using the intraclass correlation coefficient (ICC) and Cronbach's alpha coefficient. As another indication of reliability, "generalizability" was also evaluated. For all analyses, a p value of <0.05 was considered statistically significant. RESULTS: ICC and Cronbach's alpha coefficients for the inter-rater reliability of the total score of the FNGS 2.0 were 0.970 and 0.979 for the first assessment, 0.973 and 0.979 for the second assessment, respectively. The intra-rater reliability ICC results for the total score of the FNGS 2.0 were 0.95, 0.976, 0.982, 0.956, 0.96 and 0.931 for the six raters, respectively. The generalizability coefficient was found as G=0.894. CONCLUSION: In this study, we adapted the FNGS 2.0 to Turkish, and confirmed its reliability and validity as a facial palsy scale. The Turkish version of the FNGS 2.0 can be safely used to assess.

Correlation between Surgical Outcome and Stage of Acquired Middle Ear Cholesteatoma: Revalidation of the EAONO/JOS Staging System.

OBJECTIVES: This study aimed to evaluate the intraoperative findings, recurrence rate, and hearing outcome of cholesteatoma surgery and correlate them with the newly proposed EAONO/JOS Joint Consensus Statement. MATERIALS AND METHODS: The records of 407 patients diagnosed with chronic otitis media and cholesteatoma between 2009 and 2017 were reviewed. After the exclusion of records with unsatisfactory surgical notes and anamnesis, 353 patients were included in the study. The 290 patients who had undergone primary surgery and 63 who had undergone revision surgery were evaluated separately. RESULTS: Total 162 of 290 (56%) patients had retraction pocket cholesteatoma and 128 of 290 (44%) patients had non-retraction pocket cholesteatoma. Eighty (28%) patients had stage I, 114 (39%) had stage II, 91 (31%) had stage III, and 5 (2%) had stage VI disease. The recurrence rate was 6.9% (20/290). The average age of these patients at the time of the second operation was 23.31±10.3 years. Twelve patients had (60%) recurrent cholesteatoma, and eight (40%) had residual cholesteatoma. Hearing outcome and surgical technique were significantly associated with the disease stage; however, the recurrence rate showed no such association. CONCLUSION: We concluded that the EAONO/JOS staging system is beneficial for estimating the postoperative hearing results and planning the surgical technique. However, there was no significant relationship between the recurrence rate and the EAONO/JOS staging system. We believe that additional factors, such as infection, ossicles, and invasion, predict the recurrence. Widespread use of the EAONO/JOS staging system will enable better evaluation of surgical outcomes and prognosis.

Validation of the Turkish version of the Sunnybrook facial grading system

Background/aim: To adapt the Sunnybrook facial grading system (SFGS) into Turkish and perform validation and reliability studies on the Turkish version. Materials and Methods: The original English version of the SFGS was translated into Turkish by performing a linguistic validity study based on international standards. The evaluators comprised 6 physicians. Evaluations were performed twice independently using the video recordings of 65 facial palsy patients. Synchronously, the House-Brackman facial grading system (HBFGS) was filled out to display concurrent validity. The intraclass correlation coefficient (ICC) and Cronbach's alpha was used for the examination of the inter- and intra-rater reliability. As another indication of reliability, the generalizability (G) was also examined. Results: The ICC for the inter-rater reliability for resting symmetry, symmetry of voluntary movement, synkinesis, and the composite score, which are 4 components of the SFGS, were determined, respectively, as 0.822, 0.956, 0.606, and 0.957 for the first evaluation, and 0.805, 0.965, 0.584, and 0.965 for the second evaluation. For the intra-rater reliability, the ICC were determined as 0.842, 0.956, 0.794, and 0.937, while the Cronbach's alpha coefficients were determined as 0.809, 0.956, 0.792, and 0.948, respectively. The G coefficient was determined as G = 0.772. For the concurrent validity, a strong correlation was found between the SFGS and HBFGS scores. Conclusion: The present study adapted the SFGS into Turkish, and demonstrated that the adapted scale was valid and reliable. The Turkish version can be used for the evaluation of facial palsy, the follow-up of treatment efficiency, and standardization in reporting outcomes with the international literature.

Detecting Intralabyrinthine Pressure Increase by Postural Manipulation with Wideband Tympanometry and Distortion Product Otoacoustic Emissions.

OBJECTIVE: Intracranial pressure increase is known to affect inner ear pressure through the cochlear and vestibular aqueducts. This finding forms a good model for inner ear pressure studies. Standard techniques used to detect this pressure increase are neither reliable nor easily repeatable or cheap. Studies with immitancemetry and otoacoustic emissions have been giving hopeful results. This study aims to confirm the results in the literature with wideband tympanometry and add a new parameter of otoacoustic emissions to inner ear pressure testing. METHODS: Wideband tympanometry (WBT) and distortion product otoacoustic emissions (DPOAE) tests were applied to 40 healthy participants in sitting, supine, and Trendelenburg positions. DPOAE were measured under ambient or peak pressure. Resonance frequency, tympanic peak pressure, 1000, 1500, 2000, 3000, 4000, and 6000 Hz frequencies in DPOAE were measured. RESULTS: The increase in the tympanic peak pressure and the decrease in resonance frequency (RF) due to position change were found statistically significant (p<0.01). Signal noise ratio (SNR) decrease at 1 kHz frequency and SNR increase at 2, 3, 6 kHz in the normal protocol, SNR decrease at 1 kHz in the pressurized protocol were found statistically significant (p<0.01). CONCLUSION: RF in WBT and 1 kHz DPOAE SNR parameters were found useful in supporting the diagnosis in pathologies that increase intracranial pressure and inner ear pressure. Future research may ease their widespread use in clinical practice as they are non-invasive and rapidly applicable.

Adaptation of "Objective Structured Assessment of Technical Skills" for Adenotonsillectomy into Turkish: A Validity and Reliability Study.

OBJECTIVE: To adapt an objective surgical assessment tool (OSATS) for adenotonsillectomy/tonsillectomy to Turkish. METHODS: A prospective longitudinal validation study was planned. Adenoidectomy items were added to the tonsillectomy OSATS. Data were collected from 80 real-time observed surgical performances. To examine interrater reliability, 25 performances were simultaneously scored by two evaluators. In total, 105 test forms were filled, and reliability and validity studies were conducted. RESULTS: Regarding reliability, Cronbach's alpha values were found to be >0.95, indicating very high internal consistency. For interrater reliability, a statistically significant positive correlation was found between the two evaluators' task-specific checklist (TSC) (p=0.0001; r=0.969) and global rating checklist (GRC) (p=0.0001; r=0.957). Between the TSC and GRC, there was a statistically significant positive correlation (p=0.0001; r=0.951). A model was developed using the generalizability theory, and the highest variances belonged to surgical processes. Regarding validity, the trainers' scores were significantly higher than the trainees' scores (p=0.0001). As surgical experience increased, both the TSC and the GRC scores significantly increased (p=0.0001). A trainee's first-ever 34 adenotonsillectomy performances were scored. A scatter plot of the obtained data showed that the trainee had gained more scores as the number of operations increased. CONCLUSION: The results indicate that adenotonsillectomy OSATS is a reliable and valid tool for the assessment of residents' surgical skills. This is the first OSATS developed for adenotonsillectomy in the Turkish literature. It is ready to be used in the operating room to provide constructive feedback and monitor the development of trainees' surgical skills in adenotonsillectomy.

An Unusual Complication of Otitis Media: Luc's Abscess.

Luc's abscess is an extremely rare complication of otitis media, caused by the spread of the middle ear infection to the subperiosteal area and its accumulation beneath the temporal muscle. Unlike other subperiosteal abscesses relating to otitis media, infection may not be associated with mastoid bone involvement. Therefore, it is defined as a benign complication of otitis media. However, its rare occurrence may lead to delayed diagnosis and treatment. Here we report a case of an 11-year-old boy diagnosed with Luc's abscess with mastoid involvement. We discuss its clinical presentation and treatment with a review of the literature.

Direct Observation of Procedural Skills in Otorhinolaryngology Training.

OBJECTIVE: To assess the experience on using direct observation of procedural skills (DOPS) by trainees and trainers and to evaluate its use during the training process of Otorhinolaryngology (ORL) residency. METHODS: This study was designed as a prospective educational research. For the quantitative assessment, the "construct validity" of the assessment tool was examined. For the qualitative assessment, the trainees and trainers' experiences regarding the use of DOPS in training process were investigated. RESULTS: A total of 55 DOPS assessment forms were filled during the study. The mean observation time was 7.14±4.83 (range: 1-20) minutes, and the mean feedback time was 2.11±2.01 (range: 0.5-10) minutes. A significant difference was detected between the first year trainees and the older ones, whereas no significant difference was observed between the third, fourth, and fifth year trainees. A statistically significant, positive correlation was found between the years of education and the average score. According to the results of the qualitative assessment, the trainees stated that they realized their technical inadequacy in some procedures and it helped them to improve their skills during their residency training. The trainers confirmed that they gave feedback after each assessment. Both the trainers and trainees suggested that specific guidelines should be prepared for every procedure. CONCLUSION: DOPS is a useful, valid, and fair tool for assessing Otorhinolaryngology trainees. The data obtained from the DOPS forms can be used for demonstrating the success of a training clinic and to evaluate the training program.

Preliminary Results of a New Experimental Model for Intratympanic Treatment.

OBJECTIVE: Corticosteroids have been applied via transtympanic route for a long time to treat the inner ear disorders. A few animal models were used to answer the questions, "How much drug goes into the inner ear?" and "How far does the drug reach through the scala tympani and/or scala vestibuli?" However, the cerebrospinal fluid contamination poses a major problem. The aims of this study were to create a new sampling model showing the dexamethasone distribution in the inner ear and to provide more reliable data about drug concentrations. METHODS: Ten Hartley strain albino guinea pigs that weighted between 400 and 600 g were used. After dexamethasone application to the left ear, they were sacrificed at two time points: after 0.5 hours (Exp 1) and after 2 hours (Exp 2). The temporal bones were immediately dissected and put into liquid nitrogen for freezing. The apex, second turn, and basal turns of the cochlea and vestibule were separated, while the bone was in the frozen state. The samples were prepared and measured with ultraviolet (UV) spectroscopy. RESULTS: The total amount of dexamethasone was statistically higher in the left ear than the control ear. Although the basal turn and vestibule were the most prominent parts, there was no statistical difference between the different parts of the inner ear at 0.5 hours. The vestibule and the apex showed the highest level of dexamethasone at 2 hours. CONCLUSION: Although the model has some limitations, it can measure dexamethasone concentrations and show the time variability in the inner ear.

Selective Window Application of Gentamicin+ Dexamethasone in Meniere's Disease.

OBJECTIVE: The purpose of the study is to prevent hearing loss when using intratympanic (IT) gentamicin for intractable Meniere's disease. MATERIALS AND METHODS: It is a retrospective case review study. Twenty five patients who had definite Meniere's disease and had either selective window application or weekly IT gentamicin were included into the study. First group (selective) had dexamethasone on the round window and gentamicin on oval window during exploratory tympanotomy procedure. The second group had IT gentamicin at weekly intervals. The degree of caloric weakness (CW), average hearing level in low pitch (HLP) (250, 500, 1000, 2000 Hz) and high pitch (HHP) (4000, 6000, 8000 Hz) were compared before and after treatment. The need for further treatment was noted. RESULTS: In the first group, the average HLP was increased from 51.6±7dB to 52.2±5.6 dB. The average HHP was increased 41.96±20.2 dB to 47.2±18.3 dB after treatment. The CW changed from 37.6±23.9 % to 54.6±30.6 %. In the second group, the average HLP was increased from 56.3±10.5 dB to 61.65±18.3 dB. The average HHP was increased 59.05±17.4 dB to 69.4±21.98 dB after treatment. The CW changed from 45.8±22.3% to 71.53±29.63 %. Both methods had statisticaly significant increase in caloric weakness. But only IT gentamicin led a significant hearing loss in HHP. CONCLUSION: The use of dexamethasone and gentamycin via different windows in the middle ear is safe and effective method for Meniere's disease in the short term. Application of dexamethasone protects not only the hearing cells but vestibular cells also.

The subscales and short forms of the dizziness handicap inventory: are they useful for comparison of the patient groups?

PURPOSE: Dizziness Handicap Inventory (DHI) is one of the most frequently used surveys for vertigo. The aim of the study was re-analyze the consistency of subscales and correlation between original and different short forms. METHOD: The data of 2111 patients were analyzed. Original three subscales, screening form of DHI and short form of DHI were evaluated. The suitability of the data set for factor analysis and factor structure was analyzed with Kaiser-Meyer-Olkin (KMO) coefficient, Bartlett's Sphericity Test, and Varimax method. Pearson correlation analysis was performed. RESULTS: Factor analysis showed that two factor solutions are more prominent in our data. The factors proposed in different studies are not in harmony with each other. There is high correlation between the original and screening and short forms of DHI. CONCLUSIONS: This study indicated that the factor structure of the scale was not consistent. It is not advised to use subscale scores for comparison especially in international level. Therefore, total score should be used rather than the scores of the subscales. Using DHI screening form instead of original 25 questions is more convenient, because it is highly correlated with the original one and has fewer questions. Implications for rehabilitation Factor structure of the DHI is not consistent enough for comparison of the international studies. Total score of DHI is reliable. Using the screening version of DHI is better, because it is highly correlated with the original form and has fewer questions (10 questions).

MRI and CT Imaging of an Intrasphenoidal Encephalocele: A Case Report.

BACKGROUND: Intrasphenoidal encephalocele (ISE) is a rare clinical entity. The incidence of congenital encephalocele is very low. Accurate diagnosis and surgical approach is of critical value. CASE REPORTS: We present a case of intrasphenoidal encephalocele in a 40-year-old man. He complained of cerebrospinal fluid (CSF) rhinorrhea and recurrent meningitis. In images of computed tomography (CT) and magnetic resonance imaging (MRI), intrasphenoidal encephalocele herniating through a defect of the left lateral sphenoid sinus wall was determined. Incisional biopsies were taken by endoscopic transnasal approach and histopathological examination revealed an encephalocele. In the differential diagnosis, ISE can be taken for inflammatory or malignant sinusoidal soft tissue masses. ISE is differentiated from other entities by demonstrating continuity with normal brain tissue. CONCLUSIONS: MRI clearly demonstrates that the herniating soft tissue is isointense with brain and continuous with brain tissue via the sphenoid sinus, thereby the treatment decision-making process is very important.