Endoscopic endonasal transclival resection of chordomas: operative technique, clinical outcome, and review of the literature.

摘要: Object. Transcranial approaches to clival chordomas provide a circuitous route the site of origin tumor often involving extensive bone drilling and brain retraction, which places critical neurovascular structures between surgeon pathology. For certain chordomas, endonasal endoscopic transclival approach is novel minimal access, but it an equally aggressive alternative providing most direct epicenter. Methods. The authors present consecutive series patients undergoing resection chordomas. Extent was determined by postoperative volumetric MR imaging divided into > 95% (p = 0.05). overall mean follow-up 18.0 months. Cranial neuropathies resolved in all 3 with cranial nerve VI palsies. One patient recurrent nasopharyngeal chordoma died disease progression; another experienced 2 recurrences before receiving radiation therapy. All surviving remain progression free. There were no intraoperative complications; however, 1 developed pulmonary embolus postoperatively. CSF leaks. Conclusions. represents less invasive more than transcranial treat moderate-sized midline skull base Longer necessary determine comparability for long-term control. Large tumors significant extension lateral carotid artery may not be suitable this approach. (DOI: 10.3171/2009.7.JNS081504) Key w or D s • clivus endoscopy minimally invasive skull base surgery