title: Combined use of maxillomandibular swing approach and neurosurgical ultrasonic aspirator in the management of extensive clival chordoma: a case report.
abstract: BACKGROUND
  Chordoma is a rare malignant tumour with an incidence of metastasis of less than 10 percent. Usually arising from clivus its posterior extension may involve the brainstem before presenting as nasal mass and obstruction. Surgery is the main mode of treatment with adjuvant radiotherapy. However surgery is rarely possible for a large intracranial lesion.
  
  
  METHODS
  We report the case of an adolescent patient with a chordoma extending posteriorly to the brainstem and anteriorly to the nasopharynx and managed by the combination of resection using a maxillomandibular swing approach and the use of a neurosurgical ultrasonic aspirator.
  
  
  CONCLUSIONS
  Maxillomandibular swing approach provides good access for large nasopharyngeal tumour extending brainstem area.
authors.affiliation: Department of ORL-HNS, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia. shahid@kb.usm.my
authors.forename: Shahid
authors.initials: S
authors.lastname: Hassan
authors.forename: Jafri M
authors.initials: JM
authors.lastname: Abdullah
authors.forename: Shah Jihan
authors.initials: SJ
authors.lastname: Wan Din
authors.forename: Zamzuri
authors.initials: Z
authors.lastname: Idris