Retrospective evaluation of endoscopic transnasal surgery treatment to clivus chordomas

Chordomas are bone tumors of notochord origin, showing locally-aggressive invasive course, histologically, low graded counts but have a high recurrence rate and rarely they can do metastasis. Clivus chordoma accounts for 0,2% of all intracranial tumors, 6% of all skull base tumors. Accepted treatment in the world is provide the largest surgical resection as possible as,without new norological deficit and save the quality of life.The tumor in first diognosis is generally have a big volume and neigbor to neurovascular structures,so commonly it is not possible to do total resection.After diognosis the average duration is 28 mounts without treatment.Many surgent suggest agressive surgery and adjuvant treatment after diognosis. However, transfascial, transoral,transpetrosal approaches cause high mortality and morbidity.Earlier, Transnasal endoskopic approaches used in selected cases that midline and no lateral extention, But last years transnasal endoskopic surgery encrease with higt tecnology and surgents experience. In our retrospective and descriptive disquisition,between january 2014 and march 2018,The patient selected who operated with transnasal endoskopic approaches in Ege Unıversity Neurosurgery Department And Definite Pathologies Are "Clivial Cordoma"; socio-demographic characteristics, findings and survivals and clinical outcomes (residual disease, postoperative complications, recurrence rate, and mortality) evaluated. İn this study we have totaly ten patient. Seven of them male(%70),3 of them female(%30).The mean age found 53,40±18,77.İn definited patolojgy result % 80 chordoma, %10 dediferansiye chordoma, %10 conromiksoid tumör viewed. İn our series,5 patients complaint is headache,3 patients is diplopi.most common complaints are headache and diplopi in our study.less common complaints are nasal obstruction and pitozis.The patients opereted with endoscopic transnasal approach technique,4 year survival calculated with Kaplan-meir method and founded mean survival 48 ± 18,98 mounts.we dont determine norolojical defisit and complications after surgery in %80 patients,%20 patient are menengitis-rhinorrhea. After surgery, the mean duration of hospitalization time was 9,10 ± 9,83 days. Endoscopic transnasal approach of clival chordomas is a safe and viable alternative to the traditional open approach,and allows an adequate extent of resection with acceptable complication rates in comparison with other approaches. our results are compatible with the literature,and shows endoskopic trans nasal approaches is a good option with low morbitide and mortality,less hospitalization time. Keywords : clivus, chordoma, endoscopic transnasal surgery