J Neurol Surg B Skull Base 2017; 78(S 01): S1-S156
DOI: 10.1055/s-0037-1600700
Oral Presentations
Georg Thieme Verlag KG Stuttgart · New York

High Gross Total Resection Rate in Clival Chordomas via Transnasal Pure Endoscopic Approach

Jens Lehmberg
1   Neurosurgery Department, Technical University of Munich, Munich, Germany
,
Ehab Shiban
1   Neurosurgery Department, Technical University of Munich, Munich, Germany
,
Bernhard Meyer
1   Neurosurgery Department, Technical University of Munich, Munich, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
02 March 2017 (online)

 

Objective: In this small series, the personal experience with the pure endoscopic transnasal skull base approach is described.

Methods: Between 2006 and 2015, 11 patients (7 female/4 male, median age 49y, range 28/79) with clivus chordomas underwent 14 resections. A pure extended endoscopic transnasal approach was used in all of the patients. All surgeries were navigated based on CT fused to MRI. A pedicled nasoseptal flap was needed in 7/11 of cases.

Results: Gross total resection was achieved in 10 and subtotal resection in 1 case during primary surgery. No new cranial nerve deficit was encountered, as well as no CSF leakage or carotid artery injury. One patient complains prolonged nasal discomfort with crusting. All patients are alive after a median follow-up of 57 months.

Conclusion: Using the pure endoscopic transnasal approach, an excellent rate (10/11) of gross total resection of clival chordomas was achieved. Furthermore, the approach related morbidity is low, no new cranial nerve deficit was encountered in this series. This technique has become the personal preference for clival chordomas.