Neuronavigation using an image-guided endoscopic transnasal-sphenoethmoidal approach to clival chordomas.
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.
Hwang
Peter Y
PY
Department of Neurosurgery, The Alfred Hospital, Monash University, Victoria, Australia.
Ho
Chi Long
CL
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