Commentary: Toward Supratotal Resection of Clival Chordoma: Combined Endoscopic Endonasal and Contralateral Transmaxillary Approaches

2018 ◽  
Vol 16 (3) ◽  
pp. E90-E90
Author(s):  
Carlos Eduardo da Silva
Keyword(s):  
Endoscopic Endonasal ◽  
Clival Chordoma ◽  
Supratotal Resection

Supratotal Resection of Residual Clival Chordoma With Combined Endoscopic Endonasal and Contralateral Transmaxillary Approaches: 2-Dimensional Operative Video

2018 ◽  
Vol 16 (3) ◽  
pp. E88-E89 ◽  
Author(s):  
Philippe Lavigne ◽  
Eric W Wang ◽  
Juan C Fernandez-Miranda
Keyword(s):  
Skull Base ◽  
Surgical Resection ◽  
Abducens Nerve ◽  
Surgical Anatomy ◽  
Petrous Apex ◽  
Complication Rates ◽  
Curative Intent ◽  
Endoscopic Endonasal ◽  
Clival Chordoma ◽  
Supratotal Resection

Abstract The optimal treatment for skull base chordomas is gross total resection followed by radiotherapy and not radiation of partially resected tumors. Supratotal resection, defined as removal beyond all involved bone and dura, is ideal but difficult to achieve.  In this video, we present the case of a 37-yr-old man with new onset of progressive cranial nerve sixth palsy and a skull base lesion compatible with clival chordoma. He underwent partial surgical resection at an outside institution via transcranial approach, with significant tumor residual at the clivus, dorsum sella, posterior clinoids, and petrous apex, extensive dural invasion, and intradural extension with attachment to the basilar artery and its long perforating branches.  Supratotal surgical resection was achieved using an endoscopic endonasal transclival approach, ipsilateral transpteryoid approach to the foramen lacerum for carotid artery mobilization, bilateral interdural transcavernous approach with posterior clinoidectomies, and con-tralateral transmaxillary approach to the petrous apex. Reconstruction was performed in a multilayer fashion with fascia lata and fat grafts, extended nasoseptal flap, a lumbar drainage for 3 d. No cerebrospinal fluid leak occurred, and the abducens nerve palsy significantly improved at 3-mo follow-up. Proton therapy is planned.  Recent advances in endoscopic endonasal surgery allow for very high rates of complete and even supratotal resection despite the challenging location. A long learning curve to acquire the technical skills and complex surgical anatomy is required to decrease complication rates and achieve maximal resection in chordomas. Reoperations are more challenging and risky; therefore, first attempt should have curative intent.  The patient signed informed consent including the use of photographic and video material for educational or academic purposes

Endoscopic Endonasal Surgery for Clival Chordoma

2015 ◽  
Vol 76 (S 01) ◽  
Author(s):  
Matteo Zoli ◽  
Diego Mazzatenta ◽  
Adelaide Valluzzi ◽  
Pasquini Ernesto ◽  
Giorgio Frank
Keyword(s):  
Endoscopic Endonasal Surgery ◽  
Endonasal Surgery ◽  
Endoscopic Endonasal ◽  
Clival Chordoma

Extended endoscopic endonasal surgery for clival chordoma and chondrosarcoma: Our experience in 14 cases

2018 ◽  
Vol 29 (4) ◽  
pp. 201-208
Author(s):  
Diego Culebras ◽  
Jorge Torales ◽  
Luis Alberto Reyes ◽  
Luis Zapata ◽  
Sergio García ◽  
...  
Keyword(s):  
Endoscopic Endonasal Surgery ◽  
Endonasal Surgery ◽  
Endoscopic Endonasal ◽  
Clival Chordoma

scholarly journals Endoscopic endonasal resection of a clival chordoma with massive brainstem compression

2020 ◽  
Vol 2 (2) ◽  
pp. V12
Author(s):  
Mostafa Shahein ◽  
Thiago Albonette-Felicio ◽  
Giuliano Silveira-Bertazzo ◽  
Rafael Martinez-Perez ◽  
Marcus Zachariah ◽  
...  
Keyword(s):  
Cranial Nerves ◽  
Csf Leak ◽  
Facial Weakness ◽  
Panoramic View ◽  
Total Resection ◽  
Endoscopic Endonasal ◽  
Clival Chordoma ◽  
Brainstem Compression ◽  
History Of ◽  
Brain Retraction

Chordomas are rare tumors that occur at an incidence rate of 0.8 per 100,000. Thirty-five percent of chordomas occur in the spheno-occipital region. We present a case of a clival chordoma that had severe brainstem compression. The patient had a 1-year history of slurred speech and left facial weakness (House-Brackmann 3). The endoscopic endonasal transclival approach gave a panoramic view of the region without the necessity of brain retraction or manipulation of the surrounding cranial nerves. Gross-total resection was achieved and no CSF leak was encountered postoperatively. The left facial weakness improved to House-Brackmann 1.The video can be found here: https://youtu.be/DzW9Q6ckTHw.

scholarly journals Endoscopic Endonasal Approach for Clival Chordomas

2018 ◽  
Vol 23 (1) ◽  
pp. 61-64
Author(s):  
Flávio Ramalho Romero ◽  
Sérgio Listik
Keyword(s):  
Surgical Treatment ◽  
Radical Resection ◽  
Transsphenoidal Approach ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Endoscopic Endonasal ◽  
Clival Chordoma

Chordomas of the clivus are aggressive lesions which arise from the remnants of the primitive notochord and pose unique diagnostic and management challenges. Radical resection of chordomas has been recommended for better outcomes and their surgical treatment has been challenging to neurosurgeons for many years. Transbasal, orbitozygomatic, subtemporal,transcondylar, transmaxillary, and extended transsphenoidal techniques have been proposed. We report a case of clival chordoma treated by endonasal endoscopic transsphenoidal approach. 

Endoscopic Endonasal Approach for Clival Chordoma with Subarachnoid Invasion: A Two-Dimensional Step-by-Step Operative Video

2020 ◽  
Vol 142 ◽  
pp. 391
Author(s):  
Thiago Albonette-Felicio ◽  
Giuliano S. Silveira-Bertazzo ◽  
Rafael Martínez-Pérez ◽  
Mostafa Shahein ◽  
Marcus Zachariah ◽  
...  
Keyword(s):  
Two Dimensional ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Endoscopic Endonasal ◽  
Clival Chordoma

Endoscopic Endonasal Surgery for Clival Chordoma and Chondrosarcoma

ORL ◽  
2008 ◽  
Vol 70 (2) ◽  
pp. 124-129 ◽  
Author(s):  
Qiuhang Zhang ◽  
Feng Kong ◽  
Bo Yan ◽  
Zhili Ni ◽  
Haisheng Liu
Keyword(s):  
Endoscopic Endonasal Surgery ◽  
Endonasal Surgery ◽  
Endoscopic Endonasal ◽  
Clival Chordoma

scholarly journals Endoscopic Removal of Clival Chordoma

2017 ◽  
Vol 10 (1) ◽  
pp. 28-31
Author(s):  
Jitendra S Yadav ◽  
Vineet Kumar ◽  
Siva Selvaraj ◽  
Chander Bhan ◽  
Manish Pandey
Keyword(s):  
Vision Loss ◽  
Histopathological Examination ◽  
Cranial Nerves ◽  
Endoscopic Removal ◽  
Rare Presentation ◽  
Tissue Mass ◽  
Endoscopic Endonasal ◽  
Primary Bone Tumor ◽  
Clival Chordoma ◽  
Base Of The Skull

ABSTRACT Clivus chordomas are locally aggressive benign, with primary bone tumor arising from remnant of notochord anywhere from the coccyx to the base of the skull, in either a midline or paramedian position. The tumors show rare presentation and relatively common recurrence rate. Intracranial chordomas usually arise from the region around the clivus and account for about a third of all chordomas. Clival chordomas rarely metastasize and become symptomatic after local invasion to cranial nerves and skull base structure. Diagnosis is based on computed tomography scan/magnetic resonance imaging findings and histopathological examination of soft tissue mass. Complete surgical resection is the primary line of management with or without radiotherapy. We are presenting a case of clival chordoma of a 35-year-old female who presented with diminished vision and headache since 6 months. After evaluation, the patient was treated with endoscopic endonasal transsphenoidal resection of the tumor. After surgery, the patient showed relief from headache and slight improvement in vision loss. How to cite this article Yadav JS, Kumar V, Selvaraj S, Bhan C, Pandey M. Endoscopic Removal of Clival Chordoma. Clin Rhinol An Int J 2017;10(1):28-31.

scholarly journals Iatrogenic Seeding of Clival Chordoma after Endoscopic Endonasal Surgery

2017 ◽  
Vol 78 (S 01) ◽  
pp. S1-S156
Author(s):  
Georgios Zenonos ◽  
David Fernandes-Cabral ◽  
Mathew Geltzeiler ◽  
Eric Wang ◽  
Juan Fernandez-Miranda ◽  
...  
Keyword(s):  
Endoscopic Endonasal Surgery ◽  
Endonasal Surgery ◽  
Endoscopic Endonasal ◽  
Clival Chordoma
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