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Endoscopic Endonasal Surgery for Cranial Base Chondrosarcomas.
Francisco Vaz-Guimaraes1, Juan C Fernandez-Miranda2, Maria Koutourousiou3
1Department of Neurosurgery, Baylor College of Medicine.
Operative Neurosurgery (Hagerstown, Md.)
|August 26, 2017
Summary
Endoscopic endonasal approaches (EEAs) offer a viable option for cranial base chondrosarcoma (CBC) resection, especially when combined with open surgery for complex cases. This technique achieves high resection rates with acceptable complications.
Area of Science:
- Neurosurgery
- Otolaryngology
- Oncology
Background:
- Cranial base chondrosarcomas (CBCs) are typically treated with microsurgical resection via open approaches.
- Endoscopic endonasal approaches (EEAs) have been rarely reported for CBC management.
Purpose of the Study:
- To evaluate the institutional experience with EEAs for CBC resection.
- To analyze surgical outcomes, complications, and recurrence predictors.
Main Methods:
- Retrospective review of 35 patients undergoing EEA for CBC between 2004 and 2013.
- Analysis of surgical outcomes, extent of resection, complications, and recurrence.
Main Results:
- Gross-total resection was achieved in 62.9% of patients; near-total resection in 31.4%.
- Larger tumors correlated with incomplete resection (P=.004).
- Complications included CSF leak (P=.015) and cranial neuropathy (P=.037); combined approaches were needed for posterolateral extension (P=.017).
Conclusions:
- EEAs are a suitable option for CBCs without significant posterolateral extension.
- EEAs can be combined with open approaches for maximal resection and acceptable morbidity.
