Combined microscopic transoral and endoscopic endonasal approach for a clival chordoma: A case report and literature review.

Surgical neurology international Pub Date : 2024-10-25 eCollection Date: 2024-01-01 DOI:10.25259/SNI_323_2024

Marco Antonio Munuzuri-Camacho, Ricardo Palacios-Rodriguez, Jorge Alanis-Mendizabal, Tomas Moncada-Habib, Marcos V Sangrador-Deitos, Obet Jair Canela-Calderon, Victor Alcocer-Barradas

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Abstract

Background: Chordomas are primary bone tumors derived from the embryonic notochord. They represent 1-4% of all malignant bone tumors. They have a predominantly extra-axial location, arising in the clival region in 35% of reported cases. The prognosis is generally poor, and radical resection remains the first-line treatment. This study aims to describe a case of a clival chordoma that was resected through a combined microscopic transoral and endoscopic endonasal approach, with excellent clinical outcomes.

Case description: A 24-year-old woman with low cranial nerve symptomatology was admitted for a two-stage surgical approach. An occipital-cervical fixation was performed in the first stage, while a combined endonasaltransoral resection was performed later for tumor resection.

Conclusion: Microscopic transoral and endoscopic endonasal approaches offer advantages for treating clival chordomas, with careful consideration of anatomical constraints and potential for postoperative recurrence being essential in approach selection.

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经口显微镜和内窥镜鼻内镜联合方法治疗clival脊索瘤：病例报告和文献综述。

背景：脊索瘤是源自胚胎脊索的原发性骨肿瘤。它们占所有恶性骨肿瘤的 1-4%。脊索瘤主要发生在轴外，35%的病例发生在clival区域。预后一般较差，根治性切除仍是一线治疗方法。本研究旨在描述一例通过经口显微镜和鼻内镜联合方法切除的clival脊索瘤，该病例取得了良好的临床疗效：患者是一名 24 岁女性，伴有低颅神经症状，入院后接受了两阶段手术治疗。第一阶段进行了枕颈固定术，随后进行了鼻内镜经口联合肿瘤切除术：结论：显微镜下经口和内窥镜下腔内方法在治疗蝶骨脊索瘤方面具有优势，在选择方法时必须仔细考虑解剖限制和术后复发的可能性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Surgical neurology international

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