TY - JOUR T1 - Extended endoscopic endonasal surgery for clival chordoma and chondrosarcoma: Our experience in 14 cases JO - Neurocirugía T2 - AU - Culebras,Diego AU - Torales,Jorge AU - Reyes,Luis Alberto AU - Zapata,Luis AU - García,Sergio AU - Roldán,Pedro AU - Langdon,Cristóbal AU - Alobid,Issam AU - Enseñat,Joaquim SN - 25298496 M3 - 10.1016/j.neucie.2018.03.001 DO - 10.1016/j.neucie.2018.03.001 UR - https://www.revistaneurocirugia.com/en-extended-endoscopic-endonasal-surgery-for-articulo-S2529849618300236 AB - ObjectiveTo report our experience in the management of chordoma and chondrosarcoma with extended endoscopic endonasal surgery. MethodWe performed a retrospective analysis of a series of 14 patients with clival chordoma or chondrosarcoma who had extended endoscopic endonasal surgery from 2008 to 2016 performed by the same multidisciplinary team. ResultsWe had fourteen patients (male/female 2:1), with a mean age of 49 years for chordoma and 32 for chondrosarcoma. The most common clinical presentation was diplopia in 78.5% of cases, followed by dysphagia in 28.6%. Histologically, 71.4% were chordomas and 28.6% were chondrosarcomas. In addition, invasion of at least two-thirds or more of the clivus was found in 81% of the cases; in 57.1% there was intradural invasion, and in 35.7% invasion of the sella turcica. In 42.8% of cases, the degree of resection was total and in 21.5% subtotal. The most common complication was CSF fistula, occurring in 28.6% of the cases, with only one case requiring surgery to repair it. Adjuvant treatment with Proton Beam was performed in 35.7% of cases and with conventional radiotherapy in 21.5%. Mean follow-up was 53.5 months and tumour recurrence or progression was found in 21.5% of the cases, two of which had not received adjuvant treatment. There were no deaths. ConclusionThe extended endoscopic endonasal approach (EEEA) performed by an experienced team is a good alternative for the management of these lesions. Intradural invasion may be related to an increased risk of complications and worse clinical presentation, in addition to a lower rate of total resection. ER -