[Surgical Strategy for Skull Base Chordoma:Recent Advent of Neuroendoscopic Surgery]

Skull base chordoma is a rare bone tumor that is predominantly found in the clival area and considered to originate from the notochordal remnants. Chordoma is characterized by an aggressive nature and has a high risk of repeated recurrence despite multimodal treatments, including extensive surgical resection and high-dose radiotherapy. Thus, extensive surgical resection of the tumor and adjacent bony structures is strongly recommended. However, surgery was difficult because of the deep location of the lesion and involvement of important anatomies such as the cranial nerves and internal carotid arteries. Recent advent of endoscopic technology has changed visibility of the surgical field and accessibility, and surgical outcomes of this intractable tumor have dramatically changed. In this article, we present our surgical strategy of skull base chordoma aiming for radical surgical resection, focusing on the neuroendoscopic skull base surgery.