The microscopic extended transsphenoidal approach for the treatment of clival chordomas / 中华显微外科杂志

ABSTRACT

@#Objective To evaluate the application of microscopic extended transsphenoidal approach in surgery for clival chordomas. Methods Nine patients with clival chordomas were managed by microscopic extended transsphenoidal approach from August 2007 to March 2008 with the assistance of neuro-navigation. Among those, 3-D stereoscopic virtual reality images of 4 cases were reconstructed successfully,which could identify the relationship between the tumors and surrounding structures and conduced to the operations. Results Total removal was achieved in 3 cases,which was confirmed by the imaging-scopy after the operations, subtotal removal in 6 cases. Because of the invasion of the subdural space by the tumor,CSF leakage occurred in 2 cases after the tumors were removed, which was cured by the reconstruction of the cranial base with the fat tissue and albumin gel. Conclusion The microscopic extended trans spbenoidal approach is a viable, minimally invasive alternative for surgical treatment of clival tumors. By this approach, the clivus including the anterior skull base and cavernous sinus can be exposed conveniently.