title: Neuronavigation using an image-guided endoscopic transnasal-sphenoethmoidal approach to clival chordomas.
abstract: OBJECTIVE
  Surgical approaches described for resection of clival tumors have been complicated, extensive, traumatic, and invasive. They are also associated with significant mortality and morbidity rates. We describe a minimally invasive, endoscopic transsphenoidal surgical treatment for clival tumors.
  
  
  METHODS
  Three men, aged 43, 46, and 66 years, each presented with a history of headaches, diplopia, and multiple cranial nerve deficits. All preoperative magnetic resonance imaging scans showed large clival tumors. A neuronavigational image-guided endoscopic transnasal-sphenoethmoidal approach was performed to resect the clival tumors.
  
  
  RESULTS
  All three patients had near-total removal of clival tumors using this method, and the histology revealed chordomas. They underwent postoperative adjuvant radiotherapy. No complications were encountered. All patients were able to resume their usual activities on the same day after surgery. Furthermore, this technique greatly reduced patient discomfort, hastened recovery, and shortened the hospital stay.
  
  
  CONCLUSIONS
  The neuronavigation image-guided transsphenoidal approach is a viable, minimally invasive alternative for surgical treatment of clival tumors.
authors: Department of Neurosurgery, The Alfred Hospital, Monash University, Victoria, Australia.
authors: Peter Y
authors: PY
authors: Hwang
authors: Chi Long
authors: CL
authors: Ho
mesh_terms: D000328:Adult; D000368:Aged; D002817:Chordoma / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000601:surgery; D044583:Neuroendoscopy / Q000379:methods*; D038361:Neuronavigation / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods*; D019292:Skull Base Neoplasms / Q000601:surgery*; D013100:Sphenoid Bone / Q000601:surgery*; D014057:Tomography, X-Ray Computed