• M Messerer, G Cossu, P Pasche, C Ikonomidis, C Simon, E Pralong, M George, M Levivier, and R T Daniel.
• Département des neurosciences cliniques, service de neurochirurgie, centre hospitalier universitaire Vaudois, université de Lausanne, rue du Bugnon 44, 1011 Lausanne, Switzerland; Département de neurochirurgie, hôpital Kremlin-Bicêtre, université de Paris Sud, 94270 Paris, France. Electronic address: Mahmoud.messerer@chuv.ch.
• Neurochirurgie. 2016 Jun 1; 62 (3): 136-45.

ObjectiveTo report our experience with the Extended endoscopic endonasal approach (EEEA) for clival and paraclival tumors.DesignRetrospective analysis of a consecutive series of patients.ResultsEleven patients were considered: 3 chordomas, 3 meningiomas, 3 metastatic lesions, one chondroma and one chondrosarcoma. Gross total resection (GTR) was achieved in all chordomas and in chondromas with patients free of disease at the last follow-up. The chondrosarcoma was first operated on using a transfacial approach and endoscopy was performed for local progression with subtotal resection. The meningiomas were treated by a combination of transcranial and endoscopic approach due to their extension. The resection was subtotal and the residue treated by radiosurgery. Two patients with rhinopharyngeal carcinoma underwent palliative debulking. One metastatic melanoma that underwent GTR experienced remission. Two patients had postoperative cranial nerve palsy. No other complications were observed.ConclusionsEEEA allows a direct access to the skull base. Through a minimal access, it limits the incidence of neurological morbidities. For midline epidural clival tumors, EEEA allows a total excision. It also offers an excellent access to the clival component of intradural lesions. A combined approach permits good tumor control with minimal complications.Copyright © 2016 Elsevier Masson SAS. All rights reserved.

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