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The meningoencephalocele might have originated at a small dehiscence just lateral to the foramen rotundum, which is typical of temporal lobe encephaloceles.
The endoscopic transpterygoid approach--that is, an endoscopic approach through the maxillary sinus and pterygopalatine fossa and on to the pterygoid process--can provide direct access to the floor of the middle cranial fossa in the region of the foramen rotundum.