[Transmaxillary approach for micro resection of clivus tumors, clinical analysis of 16 cases].
OBJECTIVE
To investigate the indications, key point, advantages, and disadvantages of transmaxillary approach for microsurgical removal of clivus tumors.


METHODS
The clinical data of 16 consecutive patients with clivus tumors operated upon through transmaxillary approach, based on Le Fort I ostectomy, July 1999 to May 2002 were retrospectively reviewed.


RESULTS
Of the 16 patients, 8 patients suffered from chordoma, 2 from angiofibroma, 1 from pituitary adenoma, 1 from chondroma, 1 from adenocarcinoma of grade II, 1 from mucoid cyst, 1 from myeloma, and 1 from fibrous dysplasia of bone. Four out of the 16 cases were with recurrent tumors after operation performed in other hospitals. The operation field of all 16 patients was satisfactorily exposed. The tumors of 10 cases were totally removed under microscope, and 6 tumors were subtotally removed. The complications included rhinorrhea in 1 case and malocclusion in 3 cases. There was no operative mortality. All patients were followed up for 6 approximately 40 months (ion average 20 months) with MRI. Four of them had local recurrence within 1 year, 1.5 years, 2 years, and 9 months respectively after operational and have lived with tumors till now. The remainders had resumed their normal life.


CONCLUSIONS
An ideal approach, transmaxillary approach facilitates the resection of clivus tumors, with satisfying exposure and fewer complications.
Liu
Ning
N
Department of Neurosurgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
Zhang
Xiao-Biao
XB
Xing
Guang-Qian
GQ
Yin
Lin
L
Chen
Ning
N
Chen
Hai-Feng
HF
Zhu
Feng-Yi
FY
Geng
Xiao-Zeng
XZ
Fu
Zhen
Z
D000236:Adenoma / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D002817:Chordoma / Q000601:surgery; D003388:Cranial Fossa, Posterior; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D019635:Neurosurgical Procedures / Q000379:methods; D010254:Paranasal Sinus Diseases / Q000601:surgery; D010911:Pituitary Neoplasms / Q000601:surgery; D012189:Retrospective Studies; D019292:Skull Base Neoplasms / Q000601:surgery*