title: Corridor surgery: the current paradigm for skull base surgery.
abstract: BACKGROUND
  Clival chordomas are rare tumors, especially in the pediatric population. In this report, we present the case of a 3-year-old boy who was found to have a large posterior pharyngeal, clival, and posterior fossa tumor detected on a CT scan after a closed head injury.
  
  
  CONCLUSIONS
  Further questioning revealed a history of ataxia and dysphagia. Imaging confirmed severe extrinsic brain stem compression. The tumor was resected in multiple stages utilizing a minimally invasive endoscopic endonasal technique along with open transfacetal, transcondylar approach through the carotid-vertebral window. The child suffered no permanent complications as a result of our treatment and his dysphagia significantly improved. Although a complete resection was not feasible due to vascular encasement by the tumor, extensive decompression was obtained with minimal morbidity.
  
  
  CONCLUSIONS
  We present this case to illustrate a new paradigm of skull base surgical approaches for large clival lesions in pediatric patients that allows aggressive resection with minimal morbidity.
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Pirris
authors.forename: Ian F
authors.initials: IF
authors.lastname: Pollack
authors.forename: Carl H
authors.initials: CH
authors.lastname: Snyderman
authors.forename: Ricardo L
authors.initials: RL
authors.lastname: Carrau
authors.forename: Richard M
authors.initials: RM
authors.lastname: Spiro
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Tyler-Kabara
authors.forename: Amin B
authors.initials: AB
authors.lastname: Kassam
mesh_terms: D002675:Child, Preschool; D002817:Chordoma / Q000473:pathology / Q000601:surgery*; D004724:Endoscopy / Q000379:methods; D006801:Humans; D015192:Infratentorial Neoplasms / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D019635:Neurosurgical Procedures / Q000379:methods; D019291:Skull Base / Q000601:surgery*; D019292:Skull Base Neoplasms / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed