Archive | 2019
Endoscopic Management of Clival Chordomas and Chondrosarcomas
Abstract
Abstract Successful management of malignant pathology of the clivus and extending into the posterior fossa continues to be a formidable challenge to the skull base surgeon. While legends of surgery invented approaches to the skull base, these often came at significant morbidity to the patient and were difficult to inculcate to subsequent generations given the narrow surgical corridors one could use to access these central parts of the skull base. With the advent of extended endonasal skull base surgery and advances in endoscopy, instrumentation, and surgical navigation technologies, transclival skull base surgery for chordoma and chondrosarcoma has gained promising new momentum and evidence for efficacy. In this chapter, we highlight the advantages, disadvantages, anatomy, surgical principles, postoperative considerations, and complications associated with endoscopic transclival approaches to the skull base for resection of chordomas and chondrosarcomas.