The Endoscopic Endonasal Approach for Extradural and Intradural Clivus Lesions

摘要: Objective To report the use of endoscopic transnasal transclival approach to treat tumors involving clivus region. Methods The clinical records 38 patients with lesions were retrospectively reviewed determine surgical technique used. All surgically treated using any options at Sao Paulo Skull Base Center from 2000–2011. A transsphenoidal, transpterygoidal, retropharyngeal, or a combination approaches was chosen based on tumor topography. Results Chordomas most frequent (26 38), followed by chondrosarcoma (2 38). Biopsy only performed in 6 metastasis clivus, and 1 patient fibrous dysplasia underwent planned partial resection. Gross total resection (GTR) achieved 15 31 (48%) indications for GTR. For centrally located tumors, GTR 75% (15 20 patients). Fistula complication (6 31; 19%) but much lower recent series nasoseptal flap (1 16; 6%). Tumors lateral extensions previous treatment had worst results. presence intradural extension not limiting factor Conclusion Endoscopic surgery is an alternative lesions, and, expert hands, this can obtain good Lateral factors that could make more difficult. Intradural did limit radicality removal.