title: Surgical Treatment of Skull Base Tumors, Extending to Craniovertebral Junction.
abstract: OBJECTIVE
  To conduct a comparative analysis of 2 groups of patients with skull base chordomas extending onto the craniovertebral junction, who underwent surgical treatment using extracranial approaches with and without craniocervical fusion.
  
  
  METHODS
  The study group included 29 patients with skull base chordomas, extending to the craniovertebral junction, who were operated on from 2000 to 2015. The patients underwent the following surgical treatment: posterior craniocervical fusion followed by tumor removal using transoral and combined transoral and transnasal approaches. The reference group included 21 patients with the same disease, who underwent tumor removal surgery using the transoral approach without craniocervical fusion.
  
  
  RESULTS
  In the study group, in 27.5% of all cases (8 patients), the tumors were removed radically; in 65.5% of all cases (19 patients), the tumors were removed subtotally; and in 7% of all cases (2 patients), the tumors were removed partially. In the reference group, the extent of surgical radicality was as follows: radical, 0%; subtotal, 19% (4 cases); partial, 81% (17 cases).
  
  
  CONCLUSIONS
  Use of the proposed surgical technique in clinical practice may help increase the radicality of tumor excisions, decrease the number of postoperative complications, accelerate the rehabilitation process, and increase the quality of life in patients with skull base tumors extending to the craniovertebral junction.
authors.affiliation: Department of Neurooncology, the N.N. Burdenko Neurosurgery Institute, Moscow, Russia. Electronic address: Ashkarubo@nsi.ru.
authors.forename: Alexey Nikolaevich
authors.initials: AN
authors.lastname: Shkarubo
authors.affiliation: Department of Neurooncology, the N.N. Burdenko Neurosurgery Institute, Moscow, Russia.
authors.forename: Dmitry Nicolaevich
authors.initials: DN
authors.lastname: Andreev
authors.affiliation: Department of Spine Surgery, the N.N. Burdenko Neurosurgery Institute, Moscow, Russia.
authors.forename: Nikolai Aleksandrovich
authors.initials: NA
authors.lastname: Konovalov
authors.affiliation: Department of Spine Surgery, the N.N. Burdenko Neurosurgery Institute, Moscow, Russia.
authors.forename: Petr Vladimirovich
authors.initials: PV
authors.lastname: Zelenkov
authors.affiliation: Department of Anesthesiology and Reanimatology, the N.N. Burdenko Neurosurgery Institute, Moscow, Russia.
authors.forename: Andrew Jurievich
authors.initials: AJ
authors.lastname: Lubnin
authors.affiliation: Department of Neurooncology, the N.N. Burdenko Neurosurgery Institute, Moscow, Russia.
authors.forename: Ilia Valerievich
authors.initials: IV
authors.lastname: Chernov
authors.affiliation: Department of Neurooncology, the N.N. Burdenko Neurosurgery Institute, Moscow, Russia.
authors.forename: Konstantin Vladimirovich
authors.initials: KV
authors.lastname: Koval
mesh_terms: D000293:Adolescent; D000328:Adult; D001269:Atlanto-Occipital Joint / Q000473:pathology / Q000601:surgery*; D002648:Child; D002817:Chordoma / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D044583:Neuroendoscopy / Q000379:methods; D019292:Skull Base Neoplasms / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Craniocervical fusion; Craniovertebral junction; Skull base; Transnasal approach; Transoral approach