TY - JOUR
T1 - Endoscopic surgery of skull base chordomas
AU - Tan, Neil
AU - Naidoo, Yuresh
AU - Oue, Sakiko
AU - Alexander, Hamish
AU - Robinson, Simon
AU - Wickremesekera, Agadha
AU - Floreani, Stephen
AU - Vrodos, Nick
AU - Santoreneos, Steve
AU - Ooi, Eng
AU - Mcdonald, Matthew
AU - Wormald, Peter-John
PY - 2012/12
Y1 - 2012/12
N2 - Objective: To assess our clinical experience in treating midline intracranial pathology using minimally invasive surgical techniques. Design: Retrospective chart review of patients undergoing endoscopic endonasal resection of clival chordomas. Setting: Two tertiary referral centers in Australia and New Zealand. Main Outcome: Measures Patients were assessed by intraoperative findings (macroscopic resection rate, tumor size, and operative complications) and clinical outcomes (residual disease, postoperative complications, recurrence rate, and mortality). Results: Fourteen patients underwent endoscopic resection of clival chordomas (seven primary, seven revision) with a mean follow-up of 41.45 months (3 to 104 months). Macroscopic resection rates were 71% and 29%, respectively. Mean operative time was 386 minutes. Overall cerebrospinal fluid (CSF) leak rate was 3/14 (21%) and, using the nasoseptal flap, it was 0/5 (0%). Two patients developed late recurrence; one died of disease and one was treated with intensity modulated radiation therapy. Overall mortality was 2/14 (14%). Conclusion: Endoscopic resection of clival chordomas is a safe and viable alternative to the traditional open approach. The nasoseptal flap is an excellentmethod of obtaining a watertight skull base closure. Furthermore, this series highlighted the fact that the primary attempt at surgery offers the best chance to achieve a total resection.
AB - Objective: To assess our clinical experience in treating midline intracranial pathology using minimally invasive surgical techniques. Design: Retrospective chart review of patients undergoing endoscopic endonasal resection of clival chordomas. Setting: Two tertiary referral centers in Australia and New Zealand. Main Outcome: Measures Patients were assessed by intraoperative findings (macroscopic resection rate, tumor size, and operative complications) and clinical outcomes (residual disease, postoperative complications, recurrence rate, and mortality). Results: Fourteen patients underwent endoscopic resection of clival chordomas (seven primary, seven revision) with a mean follow-up of 41.45 months (3 to 104 months). Macroscopic resection rates were 71% and 29%, respectively. Mean operative time was 386 minutes. Overall cerebrospinal fluid (CSF) leak rate was 3/14 (21%) and, using the nasoseptal flap, it was 0/5 (0%). Two patients developed late recurrence; one died of disease and one was treated with intensity modulated radiation therapy. Overall mortality was 2/14 (14%). Conclusion: Endoscopic resection of clival chordomas is a safe and viable alternative to the traditional open approach. The nasoseptal flap is an excellentmethod of obtaining a watertight skull base closure. Furthermore, this series highlighted the fact that the primary attempt at surgery offers the best chance to achieve a total resection.
KW - Chordoma
KW - Endonasal
KW - Endoscopic
KW - Minimally invasive
KW - Skull base
KW - Surgery
UR - http://www.scopus.com/inward/record.url?scp=84904352419&partnerID=8YFLogxK
U2 - 10.1055/s-0032-1321508
DO - 10.1055/s-0032-1321508
M3 - Article
VL - 73
SP - 379
EP - 386
JO - Journal of Neurological Surgery Part B: Skull Base
JF - Journal of Neurological Surgery Part B: Skull Base
SN - 2193-6331
IS - 6
ER -