Endoscopic Endonasal Management of Skull Base Chordomas: Surgical Technique, Nuances, and Pitfalls

Otolaryngol Clin North Am. 2016 Feb;49(1):167-82. doi: 10.1016/j.otc.2015.09.011.

Abstract

Chordoma is a rare primary bone tumor derived from transformed notochord remnants. It has a local aggressive behavior and high recurrence rates. Treatment of skull base chordomas is complex and challenging. Control of the disease relies mainly on surgical excision of the tumor, sometimes followed by high-dose radiation therapy. The main surgical goal is to achieve maximal tumor removal with minimal morbidity. Development of the expanded endoscopic endonasal approach has improved surgical and prognostic results of skull base chordomas. This article highlights important aspects of approach selection, technique, and nuances of surgical management of this tumor.

Keywords: Chordoma; Clival chordoma; Endoscopic endonasal approach; Endoscopy; Skull base chordoma.

Publication types

  • Review
  • Video-Audio Media

MeSH terms

  • Chordoma / pathology*
  • Chordoma / surgery*
  • Endoscopy / methods*
  • Humans
  • Magnetic Resonance Imaging
  • Nose / surgery
  • Plastic Surgery Procedures / methods*
  • Postoperative Complications
  • Prognosis
  • Skull Base Neoplasms / surgery*
  • Tomography, X-Ray Computed
  • Treatment Outcome