title: [Application of neuroendoscope in the treatment of skull base chordoma].
abstract: OBJECTIVE
  To further explore the application, approach, indication and prognosis of neuroendoscope treatment for skull base chordoma.
  
  
  METHODS
  A total of 101 patients of skull base chordoma were admitted at our hospital from May 2000 to April 2010. There were 59 males and 42 females. Their major clinical manifestations included headache, cranial nerve damage and dyspnea. They were classified according to the patterns of tumor growth: Type I (n = 13): tumor location at a single component of skull base, i. e. clivus or sphenoid sinus with intact cranial dura; Type II (n = 56): tumor involving more than two components of skull e. g clivus, sphenoid and nasal/oral cavity, etc. But there was no intracranial invasion; Type III (n = 32) : tumor extending widely and intradurally forming compression of brain stems and multiple cranial nerves. Based on the types of chordoma, different endoscopic approaches were employed, viz. transnasal, transoral, trans-subtemporal fossa and plus microsurgical craniotomy for staging in some complex cases.
  
  
  RESULTS
  Among all patients, total resection was achieved (n = 19), subtotal (n = 58) and partial (n = 24). In partial resection cases, 16 cases were considered to be subtotal due to a second-stage operation. Most cases had conspicuous clinical improvements. Self-care recovery within one week post-operation accounted for 58.4%, two weeks 30.7%, one month 6.9% and more than one month 1.9%. Postoperative complications occurred in 13 cases (12.8%) and included CSF leakage (n = 4) cranial nerve palsy (n = 5), hemorrhagic nasal wounds (n = 3) and delayed intracranial hemorrhage (n = 1). All of these were cured or improved after an appropriate treatment. A follow-up of 6 - 60 months was conducted in 56 cases.
  
  
  CONCLUSIONS
  Early detection and early treatment are crucial for achieving a better outcome in chordoma. Neuroendoscopic treatment plays an important role in managing those complicated cases. Precise endoscopic techniques plus different surgical approaches and staging procedures are required to improve the post-operative quality of life for patients.
authors.affiliation: Beijing Neurosurgical Institute, Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China. zyz2004520@163.com
authors.forename: Ya-Zhuo
authors.initials: YZ
authors.lastname: Zhang
authors.forename: Zong-Cheng
authors.initials: ZC
authors.lastname: Wang
authors.forename: Xu-Yi
authors.initials: XY
authors.lastname: Zong
authors.forename: Xin-Sheng
authors.initials: XS
authors.lastname: Wang
authors.forename: Song-Bai
authors.initials: SB
authors.lastname: Gui
authors.forename: Peng
authors.initials: P
authors.lastname: Zhao
authors.forename: Chu-Zhong
authors.initials: CZ
authors.lastname: Li
authors.forename: Yue
authors.initials: Y
authors.lastname: He
authors.forename: Hong-Yun
authors.initials: HY
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002817:Chordoma / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D044583:Neuroendoscopy; D019292:Skull Base Neoplasms / Q000601:surgery*; D055815:Young Adult