Our Results of Clivus Chordoma with Endoscopic Endonasal Surgery-Our Clinical Experiences

Murat Samet Ateş; Duygu Durusoy; Sevinç Eraslan; İsa Kaya; Hüseyin Biçeroğlu; Sercan Göde; Doç. Dr. Erkin Özgiray; Raşit Midilli; Mehmet Sedat Çağlı; Halil Karcı

doi:10.5152/ejra.2018.27

Our Results of Clivus Chordoma with Endoscopic Endonasal Surgery-Our Clinical Experiences

Abstract

Objective: Chordoma is a rare, primary malignant bone tumor derived from primitive notochord remnants in the skull base. Chordomas are slowgrowing, low-grade neoplasms that are more likely to cause local recurrence, but distant metastases are uncommon. The aim of this study was to report the preoperative and postoperative results of chordoma patients who underwent endoscopic endonasal surgery. Material and Methods: This study included 10 patients (8 female and 2 male) who underwent endoscopic endonasal pituitary surgery due to chordoma in the Neurosurgery and Otolaryngology Departments of a tertiary medical center between May 2014 and August 2017. All data were obtained from patients’ folders and hospital information system retrospectively by evaluating complaints, operation notes, pathology results, radiological images, and postoperative control notes. Patients were evaluated in the postoperative period for a relapse or residual tumor, additional treatment, postoperative complications, and complaints which is regressed or not. Results: The mean age was 51 years (range, 16-79). Patients were admitted to the Otolaryngology Clinic with headache reported in 2 patients, vision loss in 1 patient, vision loss with headache in 6 patients, and nasal obstruction and headache in 1 patient. A physical examination showed the abducens paralysis in 3 patients and occulomotorius paralysis in 1 patient due to tumor indentation. All patients underwent endoscopic endonasal transethmoid and transsphenoid surgery. Complete gross tumor removal was achieved with the transsphenoidal approach in 9 patients, and the transsphenoidal and far-lateral transcondylar approach in 1 patient. Conclusion: Considering the local aggressive nature of tumor, radical surgery and adjuvant radiotherapy are the main treatments modalities of chordomas located in the skull base. The endoscopic endonasal transsphenoidal approach has become the gold standard method in daily practice due to its reliability and minimal morbidity.

Keywords

References

Jägersberg M, El Rahal A, Dammann P, Merkler D, Weber DC, Schaller K. Clival chordoma: a single-centre outcome analysis. Acta Neurochir 2017; 159: 1815-23.
Zhai Y, Bai J, Gao H, Wang S, Li M, Gui S, et al. Clinical features and prognostic factors of children and adolescents with clival chordomas. World Neurosurg 2017; 98: 323-8.
Sun İ, Özduman K, Pamir M. N. Skull Base Chordomas Türk Nöroşir Derg 2014, Cilt: 24, Ek Sayı: 3, 40-6.
Crockard HA, Steel T, Plowman N, Singh A, Crossman J, Revesz T, et al. A multidisciplinary team approach to skull base chordomas. J Neurosurg 2001; 95: 175-83.
Taniguchi M, Kohmura E. Endoscopic endonasal removal of laterally extended clival chordoma using side-viewing scopes. Acta Neurochir 2012; 154: 627-32.
Chibbaro S, Cornelius JF, Froelich S, Tigan L, Kehrli P, Debry C., et al. Endoscopic endonasal approach in the management of skull base chordomas--clinical experience on a large series, technique, outcome, and pitfalls. Neurosurg Rev 2014; 37: 217-25.
Ramm-Pettersen J, Frič R, Berg-Johnsen J. Long-term follow-up after endoscopic trans-sphenoidal surgery or initial observation in clivus chordomas. Acta Neurochir 2017; 159: 1849-55.
Förander P, Bartek J, Fagerlund M, Benmaklouf H, Dodoo E, Shamikh A, et al. Multidisciplinary management of clival chordomas; long-term clinical outcome in a single-institution consecutive series. Acta Neurochir 2017; 159: 1857-68.

Wang X, Li L, Wang Y, Hu J, Zhou J, Jing Z, et al. Clinical Application of Multimodal Neuronavigation System in Neuroendoscope-Assisted Skull Base Chordoma Resection. J Craniofac Surg 2017; 28: 554-7.
Iaconetta G, Fusco M, Cavallo LM, Cappabianca P, Samii M, Tschabitscher M. The abducens nerve: microanatomic and endoscopic study. Neurosurgery 2007; 61 (3 Suppl): 7-14.
Stammberger H, Anderhuber W, Walch C, Papaefthymiou G. Possibilities and limitations of endoscopic management of nasal and paranasal sinus malignancies. Acta Otorhinolaryngol Belg 1999; 53: 199-205.
Pamir MN, Kiliç T, Türe U, Ozek MM. Multimodality management of 26 skullbase chordomas with 4-year mean follow-up: experience at a single institution. Acta Neurochir 2004; 146: 343-54.
Sindwani R, Recinos PF, Woodard TD. Endoscopic Cranial Base and Pituitary Surgery, An Issue of Otolaryngologic Clinics of North America, E-Book (Vol. 49, No. 1). Elsevier Health Sciences.
Fourney DR, Gokaslan ZL. Current management of sacral chordoma. Neurosurg Focus 2003; 15: 1-5.
Walcott BP, Nahed BV, Mohyeldin A, Coumans JV, Kahle KT, Ferreira MJ. Chordoma: current concepts, management, and future directions. Lancet Oncol 2013; 13: 69-76.
Pamir MN, Özduman K. Tumor-biology and current treatment of skull-base chordomas. In Advances and technical standards in neurosurgery (pp. 35-129). Springer, Vienna
Ouyang T, Zhang N, Zhang Y, Jiao J, Ren J, Huang T, et al. Clinical characteristics, immunohistochemistry, and outcomes of 77 patients with skull base chordomas World Neurosurg 2014; 81: 790-7.
Gay E, Sekhar LN, Rubinstein E, Wright DC, Sen C, Janecka IP. Chordomas and chondrosarcomas of thecranial base: results and follow-up of 60 patients. Neurosurgery 1995; 36: 887-96.
Kim JH, Jung HH, Chang JH, Chang JW, Park YG, Chang WS. Gamma Knife surgery for intracranial chordoma and chondrosarcoma: radiosurgical perspectives and treatment outcomes. J Neurosurg 2014; 121(Suppl 2): 188-97.
Menezes AH, Traynelis VC, Heth J. Tumors of the craniovertebral junction. Neurological Surgery; 4: 3041-72.
Laws ER. Transsphenoidal surgery for tumors of the clivus. Otolaryngol Head Neck Surg 1984; 92: 100-1.
Fatemi N, Dusick JR, Gorgulho AA, Mattozo CA, Moftakhar P, De Salles AA, Kelly DF. Endonasal microscopic removal of clival chordomas. Surg Neurol 2008; 69: 331-8.
Komotar RJ, Starke RM, Raper DM, Anand VK, Schwartz TH. The endoscope-assisted ventral approach compared with open microscope-assisted surgery for clival chordomas. World Neurosurg 2011; 76: 318-27.
Leah P, Dower A, Vescovi C, Mulcahy M, Al Khawaja D. Clinical experience of intracranial chordoma-A systematic review and meta-analysis of the literature. J Clin Neurosci 2018; 53: 6-12.
Tzortzidis F, Elahi F, Wright D, Natarajan SK, Sekhar LN. Patient outcome at long-term follow-up after aggressive microsurgical resection of cranial base chordomas Neurosurgery 2006; 59: 230-7.
Frank G, Sciarretta V, Calbucci F, Farneti G, Mazzatenta D, Pasquini E. The endoscopic transnasal transsphenoidal approach for the treatment of cranial base chordomas and chondrosarcomas. Neurosurgery 2006; 59 (Suppl 1): 50-7.
Maira G, Pallini R, Anile C, Fernandez E, Salvinelli F, La Rocca LM, et al. Surgical treatment of clival chordomas: the transsphenoidal approach revisited. J Neurosurg 1996; 85: 784-92.
Jensen AD, Nikoghosyan A, Ellerbrock M, Ecker S, Debus J, Münter MW. Re-irradiation with scanned charged particle beams in recurrent tumours of the head and neck: acute toxicity and feasibility. Radiother Oncol 2011; 101: 383-7.
Sen CN, Sekhar LN, Schramm VL, Janecka IP. Chordoma and chondrosarcoma of the cranial base: an 8-year experience. Neurosurgery 1989; 25: 931-40.
Sekhar LN, Pranatartiharan R, Chanda A, Wright DC. Chordomas and chondrosarcomas of the skull base: results and complications of surgical management. Neurosurg Focus 2001; 10: 2.
Fraser JF, Nyquist GG, Moore N, Anand VK, Schwartz TH. Endoscopic endonasal transclival resection of chordomas: operative technique, clinical outcome, and review of the literature. J Neurosurg 2010; 112: 1061-9.

Details

Primary Language

English

Subjects

Otorhinolaryngology

Journal Section

Research Article

Authors

Murat Samet Ateş This is me
0000-0003-4419-0662
Türkiye

Duygu Durusoy This is me
0000-0003-3012-6678
Türkiye

Sevinç Eraslan This is me
Türkiye

İsa Kaya
0000-0001-7096-4858
Türkiye

Hüseyin Biçeroğlu
0000-0003-2306-0826
Türkiye

Sercan Göde
0000-0002-2148-0723
Türkiye

Doç. Dr. Erkin Özgiray
0000-0002-1156-9468
Türkiye

Raşit Midilli
0000-0002-2862-9164
Türkiye

Mehmet Sedat Çağlı
0000-0003-4822-1702
Türkiye

Halil Karcı
0000-0002-1079-4428
Türkiye

Publication Date

August 1, 2018

Submission Date

May 28, 2018

Acceptance Date

June 10, 2018

Published in Issue

Year 2018 Volume: 1 Number: 2

DOI

https://doi.org/10.5152/ejra.2018.27

IZ

https://izlik.org/JA46MM22YZ

Cite

RIS / Bibtex

APA

Ateş, M. S., Durusoy, D., Eraslan, S., Kaya, İ., Biçeroğlu, H., Göde, S., Özgiray, D. D. E., Midilli, R., Çağlı, M. S., & Karcı, H. (2018). Our Results of Clivus Chordoma with Endoscopic Endonasal Surgery-Our Clinical Experiences. European Journal of Rhinology and Allergy, 1(2), 32-37. https://doi.org/10.5152/ejra.2018.27

AMA

1.Ateş MS, Durusoy D, Eraslan S, et al. Our Results of Clivus Chordoma with Endoscopic Endonasal Surgery-Our Clinical Experiences. Eur J Rhinol Allergy. 2018;1(2):32-37. doi:10.5152/ejra.2018.27

Chicago

Ateş, Murat Samet, Duygu Durusoy, Sevinç Eraslan, et al. 2018. “Our Results of Clivus Chordoma With Endoscopic Endonasal Surgery-Our Clinical Experiences”. European Journal of Rhinology and Allergy 1 (2): 32-37. https://doi.org/10.5152/ejra.2018.27.

EndNote

Ateş MS, Durusoy D, Eraslan S, Kaya İ, Biçeroğlu H, Göde S, Özgiray DDE, Midilli R, Çağlı MS, Karcı H (August 1, 2018) Our Results of Clivus Chordoma with Endoscopic Endonasal Surgery-Our Clinical Experiences. European Journal of Rhinology and Allergy 1 2 32–37.

IEEE

[1]M. S. Ateş et al., “Our Results of Clivus Chordoma with Endoscopic Endonasal Surgery-Our Clinical Experiences”, Eur J Rhinol Allergy, vol. 1, no. 2, pp. 32–37, Aug. 2018, doi: 10.5152/ejra.2018.27.

ISNAD

Ateş, Murat Samet - Durusoy, Duygu - Eraslan, Sevinç - Kaya, İsa - Biçeroğlu, Hüseyin - Göde, Sercan - Özgiray, Doç. Dr. Erkin - Midilli, Raşit - Çağlı, Mehmet Sedat - Karcı, Halil. “Our Results of Clivus Chordoma With Endoscopic Endonasal Surgery-Our Clinical Experiences”. European Journal of Rhinology and Allergy 1/2 (August 1, 2018): 32-37. https://doi.org/10.5152/ejra.2018.27.

JAMA

1.Ateş MS, Durusoy D, Eraslan S, Kaya İ, Biçeroğlu H, Göde S, Özgiray DDE, Midilli R, Çağlı MS, Karcı H. Our Results of Clivus Chordoma with Endoscopic Endonasal Surgery-Our Clinical Experiences. Eur J Rhinol Allergy. 2018;1:32–37.

MLA

Ateş, Murat Samet, et al. “Our Results of Clivus Chordoma With Endoscopic Endonasal Surgery-Our Clinical Experiences”. European Journal of Rhinology and Allergy, vol. 1, no. 2, Aug. 2018, pp. 32-37, doi:10.5152/ejra.2018.27.

Vancouver

1.Murat Samet Ateş, Duygu Durusoy, Sevinç Eraslan, İsa Kaya, Hüseyin Biçeroğlu, Sercan Göde, Doç. Dr. Erkin Özgiray, Raşit Midilli, Mehmet Sedat Çağlı, Halil Karcı. Our Results of Clivus Chordoma with Endoscopic Endonasal Surgery-Our Clinical Experiences. Eur J Rhinol Allergy. 2018 Aug. 1;1(2):32-7. doi:10.5152/ejra.2018.27