Endoscopic resection of chordomas in different clival regions.

Abstract:

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.

journal_name

Acta Otolaryngol

journal_title

Acta oto-laryngologica

authors

Hong Jiang W,Ping Zhao S,Hai Xie Z,Zhang H,Zhang J,Yun Xiao J

doi

10.1080/00016480801995404

subject

Has Abstract

pub_date

2009-01-01 00:00:00

pages

71-83

issue

1

eissn

0001-6489

issn

1651-2251

pii

793961985

journal_volume

129

pub_type

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