Endoscopic Endonasal Surgery for Cranial Base Chondrosarcomas: Comparison to Open Approaches

Objective: Chondrosarcomas represent about 6% of all cranial base tumors. Maximum cytoreductive surgery, through a variety of approaches, is the initial treatment in most cases. The goal of this study is to evaluate the outcomes of endoscopic endonasal approaches (EEA) and compare them with traditional open approaches for cranial base chondrosarcomas (CBCs), emphasizing early outcomes. Study Design: Retrospective chart review. Patients: A total of 30 patients who underwent EEA for CBC were included in the study. The extent of resection and complications were noted. These results were compared with those previously published in major modern series, where open cranial base approaches were used. Results: Total resection via EEA was achieved in 19 of our patients (63.3%) and subtotal in 9 (30%). Perioperative complications were observed in 10 patients (33.4%) and included 2 new neurological deficits, 1 vascular injury, 6 cerebrospinal fluid leak, 2 meningitis, 2 deep venous thrombosis, and 2 other general medical conditions. Review of the literature identified 132 patients who underwent open resection. Total resection was achieved in 83 patients (62.9%) and complications were reported in 42 patients (37.5%—20 patients were excluded due to lack of comparable data). Conclusions: The use of EEA for resection of CBC shows similar early results when compared with open cranial base approaches. Depending on tumor location, an EEA may be preferred.