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Total Resection of Clival Chordoma with Brainstem Invasion via Endoscopic Transnasal Approach: Technical Note
Guenther C Feigl1, Roman Bosnjak2, Daniel Staribacher3
1Department of Neurosurgery, University Hospital Tuebingen, Tuebingen, Germany; Department of Neurological Surgery, Houston Methodist Hospital, Houston, Texas, USA; Department of Minimally invasive neurosurgery, Clinic Oberwart, Oberwart, Austria.
Objective:
Clival chordomas with brainstem invasion are extremely rare; only 5 cases have been reported in the literature. In such cases total tumor resection is associated with high intraoperative risks and is a notable challenge for the neurosurgeon. However, it is the quality of surgical treatment that influences the future prognosis, despite the efficacy of proton therapy.
Methods:
We describe the clinical case of a 39-year-old male patient with the sudden onset of double vision and left trochlear nerve paresis, who was diagnosed with a clival chordoma with brainstem invasion.
Results:
The tumor was successfully resected via unilateral left mononostril endoscopic transnasal approach. The patient had a mild paresis of the left abducens nerve that improved during the postoperative period.
Conclusions:
Clival chordomas with brainstem invasion are extremely rare. In some circumstances, total tumor resection can be achieved.
