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Clinical Outcomes Using the Expanded Endoscopic Endonasal Approach for Resection of Skull Base Chondrosarcomas
Introduction: Chondrosarcomas are slow-growing malignancies of cartilaginous origin that constitute 0.15% of all intracranial and 6% of all skull base tumors. Chondrosarcomas often arise along the median and paramedian ventral skull base; therefore, their management is challenging given their involv...
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| Main Authors: | , , , , , |
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| Format: | Conference Proceeding |
| Language: | English |
| Online Access: | Get full text |
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| Summary: | Introduction:
Chondrosarcomas are slow-growing malignancies of cartilaginous origin that constitute 0.15% of all intracranial and 6% of all skull base tumors. Chondrosarcomas often arise along the median and paramedian ventral skull base; therefore, their management is challenging given their involvement of adjacent neurovascular structures. We present a series of 13 patients with skull base chondrosarcomas that were resected via an endoscopic endonasal route using a series of modular approaches.
Methods:
We identified all patients presenting with chondrosarcomas of the skull base from January 2003 to October 2008. We reviewed key elements of their clinical history, tumor volume, anatomical location, operative procedure, postoperative sequelae, complications, and length of hospital stay.
Results:
During this period 13 patients with a pathological diagnosis of chondrosarcoma underwent 16 resections via an expanded endoscopic endonasal approach (EEA). This group comprised 7 women and 6 men with ages that ranged from 22 to 80 years (mean, 43 years). Three patients had undergone previous surgery, and 1 patient had received previous radiation therapy. The most common presenting symptoms were headache and vision complaints. Tumor volumes ranged from 1.9 to 190.4 cm
3
, with a mean of 43.6 cm
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. In 15 of 16 (93.7%) procedures, >95% resection was obtained, with no associated intraoperative complications, no new postoperative neurological deficits, and 1 CSF leak. Three of the 6 patients presenting with a sixth nerve palsy had complete recovery, and the others had partial restoration of function. The hospital length of stay ranged from 1 to 9 days with a mean of 4 days.
Conclusion:
Surgery remains the treatment of choice for skull base chondrosarcomas. Completeness of the surgical resection translates into lower recurrence rates. Based on this preliminary series, the endoscopic endonasal approach is a safe and efficacious approach for the treatment of skull base chondrosarcomas. |
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| ISSN: | 1531-5010 1532-0065 |
| DOI: | 10.1055/s-2009-1222372 |