History THE FIRST intranasal encephalocele was recorded in 1813 by Richter. From 1813 until 1895, an additional seven were reported in the world literature, all of which had a poor prognosis. It was not until 1895 that Fenger successfully treated a patient with an intranasal encephalocele by means of an intranasal surgical approach, ligating the stalk and packing the area with iodoform gauze. The prognosis of nasal encephaloceles improved with the advent of antibiotic therapy, which prevented the previously uncontrolled meningeal complications associated with the surgical repair. Definition A cephalocele consists of a sac of meninges or brain substances, or both, protruding beyond the cranial confines. A meningocele consists of meninges, while an encephalocele consists of protruding brain substance and meningeal lining. Etiology Numerous theories have been formulated regarding the etiology of encephaloceles, the most acceptable one being that of St. Hilaire. He stated that encephaloceles arise in the embryo