title: Endoscopic endonasal transclival approach to a ventral pontine pediatric ependymoma.
abstract: The authors report a case of a recurrent pediatric ventral pontine ependymoma that they resected through an endonasal endoscopic transclival approach. Regarding the options for a surgical approach to ventral pontine tumors, traditional far-lateral approaches are associated with considerable morbidity due to the required muscle mobilization, brain retraction, and in-line obstruction of cranial nerves before reaching the target. The endoscopic endonasal transclival approach was made appealing by eliminating all of these concerns. The patient's fully pneumatized sphenoid sinus, laterally displaced basilar artery, and the direct ventral location of the bulky disease all further supported this unconventional choice of surgical corridor to achieve a palliative brainstem decompression of an incurable recurrence.
authors.affiliation: Departments of Neurosurgery and.
authors.forename: Prajwal
authors.initials: P
authors.lastname: Rajappa
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Margetis
authors.forename: Dimitri
authors.initials: D
authors.lastname: Sigounas
authors.forename: Vijay
authors.initials: V
authors.lastname: Anand
authors.forename: Theodore H
authors.initials: TH
authors.lastname: Schwartz
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Greenfield
mesh_terms: D000293:Adolescent; D001488:Basilar Artery; D001933:Brain Stem / Q000473:pathology / Q000601:surgery; D020295:Brain Stem Neoplasms / Q000473:pathology / Q000601:surgery*; D003388:Cranial Fossa, Posterior; D019299:Decompression, Surgical; D004806:Ependymoma / Q000473:pathology / Q000601:surgery*; D017809:Fatal Outcome; D016905:Gram-Negative Bacterial Infections / Q000209:etiology / Q000628:therapy; D006801:Humans; D008297:Male; D008581:Meningitis / Q000209:etiology / Q000628:therapy; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D044583:Neuroendoscopy; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D009666:Nose; D010166:Palliative Care / Q000379:methods*; D012086:Reoperation / Q000009:adverse effects; D013101:Sphenoid Sinus