• Wei Hong Jiang, Su Ping Zhao, Zhi Hai Xie, Hua Zhang, Junyi Zhang, and Jian Yun Xiao.
• Department of Otolaryngology, Xiang Ya Hospital, Central South University, Changsha, Hunan, China. jiangwh68@126.com
• Acta Otolaryngol. 2009 Jan 1; 129 (1): 71-83.

ConclusionThe endoscopic approaches developed for the treatment of the chordomas according to the different clival location provide the possibility for more complete tumor resection with maximal preservation of anatomic structures and reduction of the overall incidence of complications.ObjectiveThe endoscope has recently been applied in patients with chordomas, but rare studies report the various endoscopic approaches in the treatment of chordomas in the different regions of clivus. In this study, the authors present their experience with these techniques in patients with chordomas.Patients And MethodsFour chordomas in the upper-middle clivus underwent an endoscopic transseptal transsphenoidal (ETT) approach. Five macro-chordomas involving whole clivus underwent an extended ETT approach. Three chordomas in the lower clivus underwent an endoscopic transoropharyngeal (ETOP) approach. The surgical access points were designed for each patient. After safe planes were identified along the surgical access points, the tumor was fractionally removed.ResultsSeven gross total, four subtotal, and one partial resection were achieved after surgery. At 6 months to 3 years follow-up, eight patients were recurrence-free and two patients had unchanged residual tumor. One patient with recurrent chordoma underwent second surgery and subsequent intensity modulated radiation therapy (IMRT). The other patient with a recurrent chordoma died 1 year postoperation.

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