Endoscopic Approach to Clival Chordomas: The Northwestern Experience

World Neurosurgery
Rudy J RahmeJames P Chandler

Abstract

Chordomas are rare primary bone tumors with a low-grade histology but an aggressive clinical behavior characterized by local invasion and recurrence. When occurring in the skull base, their treatment is limited by proximity to critical neurovascular structures. Open surgical approaches can carry high morbidity, making the development of alternative approaches desirable. We describe our experience with endoscopic endonasal approaches to clival chordomas over 13 years. We performed a retrospective chart review of patients diagnosed with clival chordomas and treated with an endoscopic endonasal approach between 2003 and 2015 at Northwestern Memorial Hospital. We reviewed presenting symptoms, tumor location and size, extent of resection, complications, recurrence, adjuvant treatment, retreatment, and follow-up duration. A total of 23 charts were reviewed, with 17 included in our final review. Mean age was approximately 48 years. The most common presenting symptom was diplopia present in 70.6% of patients. Mean tumor volume was 20.2 cm3. Gross total resection was achieved in 52.9% of patients. With a mean follow-up period of 63.4 months, 5 patients had a recurrence. The most common complication was cerebrospinal fluid (CSF) leak, wh...Continue Reading

Citations

Feb 6, 2019·Journal of Neurosurgery·Theodore H SchwartzVijay K Anand
May 28, 2019·Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale·E ZanolettiD Zanetti
Jan 5, 2020·Acta neurochirurgica·L GiammatteiS Froelich
Feb 16, 2020·Neurosurgical Review·Francesco BelottiFrancesco Doglietto
Jun 5, 2020·Surgical Neurology International·Andrew K WongRicky H Wong
Dec 22, 2020·Laryngo- rhino- otologie·Frank Haubner, Walter Rachinger

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