Aric Park, Elie E. Rebeiz, MD, Carl Heilman, MD
Tufts Medical Center- Department of Otolaryngology, Boston, MA
PURPOSE OF STUDY
To review our experience with endoscopic endonasal approach for surgical management of clival tumors.
13 patients with clival tumors treated by endoscopic endonasal surgery between 11/9/97 and 10/2/05 were studied retrospectively. We will discuss the surgical technique.
SUMMARY OF RESULTS:
Most patients presented with diplopia (5) or headaches (4). There were 6 chordomas, 2 chondrosarcoma, 1 ossifying fibroma, 1 hamratomatous lipoma, 1 cholesterol granuloma, 1 lymphoma, and 1 metastatic Carcinoma. 8 patients had improvement in their presenting symptoms. 3 had no change. Length of stay varied from 1 to 5 days. Total tumor removal was performed in 9 cases, subtotal removal in 2 cases. Follow-up ranged from 3 to 48 months. Complications included 2 intraoperative cerebrospinal leaks which were repaired successfully during surgery, 1 episode of epistaxis, managed (how) 1 transient cranial nerve VI palsy that resolved spontaneously, and 1 nasal obstruction treated (how). There was no post operative bleeding, sinusitis or meningitis.
Endoscopic endo-nasal surgery for clivus and anterior skull base lesions is a safe alternative to traditional open approaches and has several advantages including a low morbidity, quick recovery and limited complications. The use of endoscope to perform clival tumor surgery provides excellent visualization, but requires a learning curve and a team approach.
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