Congenital sphenoid wing defect with lateral angular dermoid presenting with CSF leak after orbital surgery

Lateral angular dermoid may have associated bony defects which must be recognized before surgery. High-resolution 3-D CT scans and MRIs define these lesions very clearly. Total excision with attention to the bony defect is usually curative. CSF leak from the operative wound at the surgery or in the post-operative period signifies the intracranial connection or dural adhesion unnoticed by the Ophthalmologist before surgery.