+ 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

Surgical treatment of clival chordomas



Surgical treatment of clival chordomas



Acta Otorrinolaringologica Espanola 61(2): 135-144



Clival chordomas are benign neoplastic tumors displaying high morbidity and mortality rates. The difficulties involved in obtaining a total resection and its infiltrative nature explain this aggressiveness. We present a retrospective clinical series of 8 surgically treated cases of clival chordomas at our department from 1993 to 2006. All 8 patients underwent a total of 14 surgical procedures, 6 of which were anterior approaches (5 transmandibular), 2 subtemporal-preauricular, 2 from the transcondylar lateral edge and 2 transcochlear. In 7 patients the surgery was performed with curative intent. In 2 cases it was necessary to perform the surgery sequentially, in two steps. Total resection was achieved in 58% of patients. Average follow up was 40 months. Two patients died due to local recurrence, one patient died in the postoperative period and another died due to causes which were not related with the tumor. The low incidence of clival chordomas makes it difficult to carry out random clinical studies of its management. The treatment of choice is surgery, supplemented by radiotherapy in selected cases. We prefer to use the transmandibular approach, combined with transcondylar lateral edge approach when the occipital condyle is infiltrated. For lateral extensions, we use the subtemporal-preauricular or transpetrosal approaches. New radiotherapy modalities provide an effective treatment of tumoural residues. Extradural approaches imply anatomical regions which are familiar for otolaryngologists. Specific knowledge about the limitations of each approach is essential in order to avoid unnecessary morbidity and incomplete resections.

Please choose payment method:






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

Accession: 056036754

Download citation: RISBibTeXText

PMID: 20096394

DOI: 10.1016/j.otorri.2009.10.012


Related references

Surgical treatment of clival chordomas: the transsphenoidal approach revisited. Journal of Neurosurgery 85(5): 784-792, 1996

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

Surgical management of clival chordomas in children. Operative Techniques in Otolaryngology-Head and Neck Surgery 30(1): 63-72, 2019

Clival chordomas: A pathological, surgical, and radiotherapeutic review. Head and Neck 36(6): 892-906, 2014

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

Transmaxillary approach for surgical removal of clival chordomas: study of 10 cases. Zhonghua Yi Xue Za Zhi 85(20): 1379-1381, 2005

Hyperfractionated high-dose proton beam radiotherapy for clival chordomas after surgical removal. British Journal of Radiology 89(1063): 20151051, 2016

Tailored surgical strategy in clival chordomas: an extraordinary selection bias that limits approach comparison. Journal of Neurosurgical Sciences 62(4): 519-521, 2018

Ep-1296 Treatment Results Of Clival Chordomas With Robotic Stereotactic Radiotherapy. Radiotherapy and Oncology 103: S492-S493, 2012

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

Clival chordomas. Australasian Radiology 37(3): 259-264, 1993

Clival chordomas in children. Acta Neurologica 2(2): 121-127, 1980

Chordomas of the clival region. Contemporary Neurosurgery 12(13): 1-7, 1990

CT appearance of clival chordomas. Journal of Computer Assisted Tomography 10(1): 34-38, 1986

Cadherins and Catenins in Clival Chordomas. The American Journal of Surgical Pathology 29(11): 1422-1434, 2005