+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Endoscopic endonasal approach for clival chordomas

Endoscopic endonasal approach for clival chordomas

Neurosurgery 64(2): 268-77; Discussion 277-8

Cranial base chordomas are difficult lesions to treat. The endoscopic endonasal approach (EEA) takes advantage of the natural sinus corridor and may provide a less invasive approach for these midline tumors. Patients undergoing EEA for chordomas were selected from a database of more than 800 consecutive patients undergoing EEA at the University of Pittsburgh Medical Center and were retrospectively evaluated. Additionally, a systematic review of the literature of endoscopic endonasally resected chordomas was performed and compared with our personal experience. Twenty patients (8 females and 12 males) underwent 26 endoscopic EEAs for cranial base chordomas. Eight chordomas (40%) were recurrent. Treatment of the 12 newly diagnosed chordomas included 8 total resections (66.7%), 2 near total resections (16.7%), and 2 subtotal resections (16.7%). Treatment of the 8 recurrent chordomas included 1 gross total resection (12.5%), 2 near total resections (25.0%), and 5 subtotal resections (62.5%). Two patients (10%) had recurrences, and 5 patients (25%) progressed during the mean follow-up period of 13 months (range, 1-45 months). Five patients (25%) underwent re-resection, 1 patient was lost to follow-up, and 1 patient died secondary to progression of disease. There was 1 intraoperative vascular complication with no sequelae. The cerebrospinal fluid leak rate was 25%, and there were no cases of bacterial meningitis. The incidence of a new permanent neurological complication was 5%. A systematic review of the literature yielded a total of 26 cases of chordomas resected via a completely endoscopic endonasal technique. Endoscopic endonasal resection of cranial base chordomas is safe once adequate experience is gained with the technique. This approach provides the potential for, at the least, similar resections compared with traditional cranial base approaches while potentially limiting morbidity.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 052965344

Download citation: RISBibTeXText

PMID: 19190456

DOI: 10.1227/01.neu.0000338071.01241.e2

Related references

Surgical results of an endoscopic endonasal approach for clival chordomas. Acta Neurochirurgica 154(5): 879-886, 2012

Endonasal endoscopic approach to clival and posterior fossa chordomas. Operative Techniques in Otolaryngology-Head and Neck Surgery 22(4): 274-280, 2011

Expanded endoscopic endonasal approach for treatment of clival chordomas: early results in 12 patients. Neurosurgery 63(2): 299-307; Discussion 307-9, 2008

Endoscopic endonasal surgery for Clival Chordomas - a single institution experience and short term outcomes. British Journal of Neurosurgery 2019: 1-6, 2019

Endoscopic Approach to Clival Chordomas: The Northwestern Experience. World Neurosurgery 110: E231-E238, 2017

Neuronavigation using an image-guided endoscopic transnasal-sphenoethmoidal approach to clival chordomas. Neurosurgery 61(5 Suppl 2): 212-7; Discussion 217-8, 2008

Endonasal microscopic removal of clival chordomas. Surgical Neurology 69(4): 331-338, 2008

Extended endoscopic endonasal approach to the clival region. Journal of Craniofacial Surgery 21(1): 245-251, 2010

Endoscopic endonasal approach for intracranial chordomas. Acta Neurochirurgica 159(10): 1847-1848, 2016

Endoscopic endonasal transclival approach and retrosigmoid approach to the clival and petroclival regions. Neurosurgery 65(6 Suppl.): 42-50; Discussion 50-2, 2010

Endoscopic transnasal approach for surgical treatment of skull base clival area chordomas (Report of 2 cases). Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 32(3): 230-232, 2018

Transoral vs. endoscopic endonasal approach for clival/upper cervical chordoma. Neurologia Medico-Chirurgica 54(12): 991-998, 2016

Transoral vs. Endoscopic Endonasal Approach for Clival/Upper Cervical Chordoma. Neurologia medico-chirurgica 54(12): 991-998, 2014

Combined endoscopic endonasal and posterior cervical approach to a clival chordoma. Journal of Clinical Neuroscience 17(11): 1463-1465, 2011

Extended endoscopic endonasal approach to clival and paraclival tumors: Indications and limits. Neuro-Chirurgie 62(3): 136-145, 2017