Endoscopic endonasal resection of skull base chondrosarcomas: Technique and early results

Nelson Moussazadeh, Charles Kulwin, Vijay K. Anand, Jonathan Y. Ting, Caryn Gamss, J. Bryan Iorgulescu, Apostolos John Tsiouris, Aaron A. Cohen-Gadol, Theodore H. Schwartz

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

OBJECT: The authors of this study sought to report the technique and early clinical outcomes of a purely endonasal endoscopic approach for resection of petroclival chondrosarcomas. METHODS: Between 2010 and 2014, 8 patients (4 men and 4 women) underwent endonasal endoscopic operations to resect petroclival chondrosarcomas at 2 institutions. The patients' mean age was 44.8 years (range 30-64 years). One of the patients had previously undergone radiation therapy and another a staged craniotomy. Using volumetric software, an independent neuroradiologist assessed the extent of the resections on MRI scans taken immediately after surgery and at the 3-month follow-up. Immediate complications and control of symptoms were also recorded. In addition, the authors reviewed the current literature on surgical treatment of chondrosarcoma. RESULTS: The mean preoperative tumor diameter and volume were 3.4 cm and 9.8 cm3, respectively. Six patients presented with cranial neuropathies. Endonasal endoscopic surgery achieved > 95% resection in 5 of the 8 patients and < 95% resection in the remaining 3 patients. One of the 6 neuropathies resolved, and the remaining 5 partially improved. One instance of postoperative CSF leakage required a reoperation for repair; no other complications associated with these operations were observed. All of the patients underwent adjuvant radiotherapy. CONCLUSIONS: According to the authors' experience, the endoscopic endonasal route is a safe and effective approach for the resection of appropriately selected petroclival chondrosarcomas.

Original languageEnglish (US)
Pages (from-to)735-742
Number of pages8
JournalJournal of neurosurgery
Volume122
Issue number4
DOIs
StatePublished - Apr 2015

Keywords

  • Chondrosarcoma
  • Clivus
  • Minimally invasive
  • Neuroendoscopy
  • Oncology
  • Petrous apex
  • Pituitary surgery
  • Skull base
  • Transpterygoid approach

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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