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World Neurosurg ; 99: 47-58, 2017 Mar.
Article in English | MEDLINE | ID: mdl-27956253

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.


Subject(s)
Atlanto-Occipital Joint/surgery , Chordoma/pathology , Chordoma/surgery , Natural Orifice Endoscopic Surgery/methods , Skull Base Neoplasms/pathology , Skull Base Neoplasms/surgery , Adolescent , Adult , Atlanto-Occipital Joint/pathology , Child , Female , Humans , Male , Neuroendoscopy/methods , Treatment Outcome , Young Adult
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