CONCLUSION: The endoscopic approaches developed for the treatment of the chordomas according to the different clival location provide the possibility for more complete tumor resection with maximal preservation of anatomic structures and reduction of the overall incidence of complications. OBJECTIVE: The endoscope has recently been applied in patients with chordomas, but rare studies report the various endoscopic approaches in the treatment of chordomas in the different regions of clivus. In this study, the authors present their experience with these techniques in patients with chordomas. PATIENTS AND METHODS: Four chordomas in the upper-middle clivus underwent an endoscopic transseptal transsphenoidal (ETT) approach. Five macro-chordomas involving whole clivus underwent an extended ETT approach. Three chordomas in the lower clivus underwent an endoscopic transoropharyngeal (ETOP) approach. The surgical access points were designed for each patient. After safe planes were identified along the surgical access points, the tumor was fractionally removed. RESULTS: Seven gross total, four subtotal, and one partial resection were achieved after surgery. At 6 months to 3 years follow-up, eight patients were recurrence-free and two patients had unchanged residual tumor. One patient with recurrent chordoma underwent second surgery and subsequent intensity modulated radiation therapy (IMRT). The other patient with a recurrent chordoma died 1 year postoperation.
CONCLUSION: The endoscopic approaches developed for the treatment of the chordomas according to the different clival location provide the possibility for more complete tumor resection with maximal preservation of anatomic structures and reduction of the overall incidence of complications. OBJECTIVE: The endoscope has recently been applied in patients with chordomas, but rare studies report the various endoscopic approaches in the treatment of chordomas in the different regions of clivus. In this study, the authors present their experience with these techniques in patients with chordomas. PATIENTS AND METHODS: Four chordomas in the upper-middle clivus underwent an endoscopic transseptal transsphenoidal (ETT) approach. Five macro-chordomas involving whole clivus underwent an extended ETT approach. Three chordomas in the lower clivus underwent an endoscopic transoropharyngeal (ETOP) approach. The surgical access points were designed for each patient. After safe planes were identified along the surgical access points, the tumor was fractionally removed. RESULTS: Seven gross total, four subtotal, and one partial resection were achieved after surgery. At 6 months to 3 years follow-up, eight patients were recurrence-free and two patients had unchanged residual tumor. One patient with recurrent chordoma underwent second surgery and subsequent intensity modulated radiation therapy (IMRT). The other patient with a recurrent chordoma died 1 year postoperation.
Authors: Rabjot Rai; Joe Iwanaga; Ghaffar Shokouhi; Marios Loukas; Martin M Mortazavi; Rod J Oskouian; R Shane Tubbs Journal: Childs Nerv Syst Date: 2018-06-28 Impact factor: 1.475
Authors: Ali M Elhadi; Kaith K Almefty; George A C Mendes; M Yashar S Kalani; Peter Nakaji; Alexander Dru; Mark C Preul; Andrew S Little Journal: J Neurol Surg B Skull Base Date: 2014-05-02
Authors: Moran Amit; Shorook Na'ara; Yoav Binenbaum; Salem Billan; Gil Sviri; Jacob T Cohen; Ziv Gil Journal: J Neurol Surg B Skull Base Date: 2014-05-27
Authors: Ryan E Little; Robert J Taylor; Justin D Miller; Emily C Ambrose; Anand V Germanwala; Deanna M Sasaki-Adams; Matthew G Ewend; Adam M Zanation Journal: J Neurol Surg B Skull Base Date: 2014-04-17
Authors: Salvatore Di Maio; Stephen Yip; Gmaan A Al Zhrani; Fahad E Alotaibi; Abdulrahman Al Turki; Esther Kong; Robert C Rostomily Journal: Ther Clin Risk Manag Date: 2015-05-26 Impact factor: 2.423