Journal of Neurological Surgery Part B: Skull Base, Table of Contents CC BY-NC-ND 4.0 · J Neurol Surg B Skull Base 2019; 80(S 04): S372-S374DOI: 10.1055/s-0039-1697979 Skull Base: Operative Videos Georg Thieme Verlag KG Stuttgart · New YorkChordoma of the Craniocervical Junction: Endoscopic Endonasal Approach Eduard H. Voormolen 1 Service de Neurochirurgie de Prof. Froelich, Université Paris Diderot, Hôpital Lariboisière, Assistance Publique—Hôpitaux de Paris, Paris, France , Pierre Olivier Champagne 1 Service de Neurochirurgie de Prof. Froelich, Université Paris Diderot, Hôpital Lariboisière, Assistance Publique—Hôpitaux de Paris, Paris, France , Sebastien Froelich 1 Service de Neurochirurgie de Prof. Froelich, Université Paris Diderot, Hôpital Lariboisière, Assistance Publique—Hôpitaux de Paris, Paris, France› Author AffiliationsRecommend Article Abstract Full Text PDF Download Keywords Keywordschordoma - craniocervical junction - endoscopy - endonasal www.thieme.com/skullbasevideos www.thieme.com/jnlsbvideos Download Figures Fig. 1 Pre- and postoperative images of the craniocervical junction chordoma. (A) It shows a preoperative sagittal T2-weighted MRI image. (B) It shows a preoperative axial T2-weighted MRI image. Note that a T2-hyperintense lesion is located in the lower clivus and the odontoid. (C) It shows the postoperative sagittal T1-weighted gadolinium enhanced MRI image. (D) shows a postoperative axial T2-weighted MRI image. These images show the fat graft used for closure, but no evident tumor remnant. MRI, magnetic resonance imaging Fig. 2 Illustration of the endoscopic endonasal surgical technique. (A) It shows the surgical route (blue arrow), and location of the heart-shaped mucosal flap that was made in the upper nasopharynx (blue crescent). This figure highlights that angled endoscopes are needed to visualize the relevant operative field (yellow translucent triangle). (B) shows the axial view, (C) shows an intraoperative endoscopic view of the incision performed to achieve a heart-shaped mucosal flap, as was utilized during this case, and (D) shows the coronal view. (B and D) They show the results of postoperative image analysis, during which we segmented the drill cavity (in blue) and projected it on the preoperative CT scan of the patient. Note that besides the inferior clivus, the superior part of the ring of C1 was also drilled slightly to reach the tumor in the odontoid. CT, computed tomography.
