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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Endoscopic endonasal approach for clival chordomas
Martina Stippler1, Paul A Gardner, Carl H Snyderman
1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA.
Neurosurgery
|February 5, 2009
Summary
Endoscopic endonasal approach (EEA) offers a safe and effective minimally invasive option for treating difficult cranial base chordomas. This technique shows potential for comparable resection rates to traditional methods with reduced patient morbidity.
Area of Science:
- Neurosurgery
- Otolaryngology
- Skull Base Surgery
Background:
- Cranial base chordomas present significant treatment challenges.
- The endoscopic endonasal approach (EEA) utilizes natural sinus pathways for tumor access.
- EEA may offer a less invasive surgical option for these midline tumors.
Purpose of the Study:
- To evaluate the safety and efficacy of the endoscopic endonasal approach (EEA) for cranial base chordomas.
- To compare outcomes of EEA for chordomas with traditional surgical methods.
- To assess the learning curve and complication rates associated with EEA for chordomas.
Main Methods:
- Retrospective analysis of 20 patients who underwent 26 EEAs for cranial base chordomas at a single institution.
- Systematic literature review of previously reported cases of endoscopic endonasally resected chordomas.
- Comparison of personal experience with published data.
Main Results:
- Of 20 patients, 12 newly diagnosed and 8 recurrent chordomas were treated.
- Resection rates varied: total (66.7%) for new, subtotal (62.5%) for recurrent tumors.
- Complications included 25% cerebrospinal fluid leak rate and 5% new permanent neurological deficits; no bacterial meningitis.
- Literature review identified 26 additional cases resected via EEA.
Conclusions:
- Endoscopic endonasal resection of cranial base chordomas is a safe procedure with accumulated experience.
- EEA provides comparable resection potential to traditional approaches.
- This minimally invasive technique may reduce patient morbidity compared to open cranial base surgery.
