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经鼻内镜入路在斜坡脊索瘤手术中的应用:病例系列

Endoscopic Endonasal Approach in Clival Chordoma Surgery: Case Series.

作者信息

Ngu Chien Ying Vincent, Tang Ing Ping, Ng Boon Han Kevin, Wong Albert S I I Hieng, Liew Donald Ngian San

机构信息

Department of Otorhinolaryngology, Sarawak General Hospital, Otorhinolaryngology - Head and Neck Surgery Department, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Department of Otorhinolaryngology, Sarawak General Hospital, Department of ORL-HNS, Faculty of Medicine and Health Sciences, University Malaysia Sarawak, 94300 Kota Samarahan, Sarawak Malaysia.

出版信息

Indian J Otolaryngol Head Neck Surg. 2021 Jun;73(2):226-232. doi: 10.1007/s12070-021-02455-6. Epub 2021 Feb 23.

Abstract

Chordomas are rare and slow-growing locally destructive bone tumors that can develop in the craniospinal axis. It is commonly found in the sacrococcygeal region whereas only 25-35% are found in the clival region. Headache with neurological deficits are the most common clinical presentations. Complete surgical resection either via open or endoscopic endonasal approaches are the main mode of treatment. Here, we report a series of 5 cases of clival chordomas which was managed via endoscopic endonasal approaches in our center. A retrospective analysis of patients who had undergone endoscopic endonasal resection of clival chordoma in Sarawak General Hospital from 2014 to 2018. A total of 5 cases were operated on endoscopically via a combine effort of both the otorhinolaryngology team and the neurosurgical team during the study period from year 2013 to 2018. From our patient, 2 were female and 3 were male patients. The main clinical presentation was headache, squinting of eye and nasopharyngeal fullness. All our patient had endoscopic endonasal debulking of clival tumor done, with average of hospital stay from 9 - 23 days. Pos-operatively, patients were discharged back well. Endoscopic endonasal resection of clival chordomas gives good surgical resection results with low morbidity rates and therefore can be considered as a surgical option in centers where the surgical specialties are available.

摘要

脊索瘤是一种罕见的、生长缓慢的局部侵袭性骨肿瘤,可发生于颅脊柱轴。它常见于骶尾区域,而仅25% - 35%发生于斜坡区域。伴有神经功能缺损的头痛是最常见的临床表现。通过开放手术或内镜经鼻入路进行完全手术切除是主要的治疗方式。在此,我们报告了一系列5例斜坡脊索瘤病例,这些病例在我们中心通过内镜经鼻入路进行治疗。对2014年至2018年在砂拉越总医院接受内镜经鼻切除斜坡脊索瘤的患者进行回顾性分析。在2013年至2018年的研究期间,共有5例患者通过耳鼻喉科团队和神经外科团队的共同努力接受了内镜手术。在我们的患者中,2例为女性,3例为男性。主要临床表现为头痛、斜视和鼻咽部饱满。我们所有患者均接受了内镜经鼻切除斜坡肿瘤,平均住院时间为9 - 23天。术后,患者康复出院。内镜经鼻切除斜坡脊索瘤手术切除效果良好,发病率低,因此在具备手术专科的中心可被视为一种手术选择。

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Endoscopic Endonasal Approach in Clival Chordoma Surgery: Case Series.经鼻内镜入路在斜坡脊索瘤手术中的应用:病例系列
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本文引用的文献

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Nasal Functions in Three-Dimensional Endoscopic Skull Base Surgery.三维内镜颅底手术中的鼻腔功能
Ann Otol Rhinol Laryngol. 2019 Mar;128(3):208-214. doi: 10.1177/0003489418816723. Epub 2018 Dec 10.
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A historical recount of chordoma.脊索瘤的历史回顾。
J Neurosurg Spine. 2018 Apr;28(4):422-428. doi: 10.3171/2017.7.SPINE17668. Epub 2018 Feb 2.
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Recent advances in understanding and managing chordomas.脊索瘤的认识与治疗新进展
F1000Res. 2016 Dec 22;5:2902. doi: 10.12688/f1000research.9499.1. eCollection 2016.
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Contemporary management of clival chordomas.斜坡脊索瘤的现代治疗
Curr Opin Otolaryngol Head Neck Surg. 2015 Apr;23(2):153-61. doi: 10.1097/MOO.0000000000000140.

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