Endoscopic surgery of skull base chordomas

Neil Tan, Yuresh Naidoo, Sakiko Oue, Hamish Alexander, Simon Robinson, Agadha Wickremesekera, Stephen Floreani, Nick Vrodos, Steve Santoreneos, Eng Ooi, Matthew Mcdonald, Peter-John Wormald

    Research output: Contribution to journalArticle

    16 Citations (Scopus)

    Abstract

    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.

    Original languageEnglish
    Pages (from-to)379-386
    Number of pages8
    JournalJournal of Neurological Surgery Part B: Skull Base
    Volume73
    Issue number6
    DOIs
    Publication statusPublished - 2012

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    Tan, N., Naidoo, Y., Oue, S., Alexander, H., Robinson, S., Wickremesekera, A., Floreani, S., Vrodos, N., Santoreneos, S., Ooi, E., Mcdonald, M., & Wormald, P-J. (2012). Endoscopic surgery of skull base chordomas. Journal of Neurological Surgery Part B: Skull Base, 73(6), 379-386. https://doi.org/10.1055/s-0032-1321508