Neuronavigation assisted Endoscopic Endonasal Surgery for Skull Base Chordomas: treatment and outcome analysis in a consecutive case series of 12 patients

Skull base chordomas can be challenging to resect, and the degree of surgical resection is highly correlated with prognosis. With the rapid development of imaging, neuronavigation, and endoscopy, these technologies provide good technical support for improving the gross total resection rate of skull base clivus chordomas. Objective : To analyze the clinical outcomes and extent of resection of neuronavigation-assisted endoscopic endonasal surgery in the treatment of skull base chordomas. Methods : We retrospectively analyzed 12 patients (six males and six females, aged 9–70 years) with skull base chordomas in the Department of Neurosurgery of Ganzhou People's Hospital from May 2018 to April 2020. Results : During the operation, 6 cases were exposed to the paraclival internal carotid artery, two patients experienced cerebrospinal fluid leakage before the operation, and four patients had tumors that broke through the dura, grew into the posterior cranial fossa, and adhered closely to the brain stem. Gross total resection was achieved in 66.67% (8 of twelve cases), and subtotal resection in 33.33% (4 of twelve cases). All patients were followed for 40–59 months after the operation. The patients' symptoms improved postoperatively. Conclusions : Neuronavigation-assisted EES is an effective approach for treating skull base chordomas.