Alshammari Dhaidan, Alanazi Haifa, Almomen Ali, Alarfaj Dalia, Taha Mahmoud, Al Saeed Fatimah Jamal
ENT Head &Neck Surgery Consultant, North Medical Tower, Arar, Saudi Arabia.
ENT Resident, University Hospital of Giessen and Marburg, Marburg, Germany.
Int J Surg Case Rep. 2025 Feb;127:110806. doi: 10.1016/j.ijscr.2024.110806. Epub 2025 Jan 5.
Different pathologies can affect the clivus region. Despite the challenging anatomical location and complexity of neuro-vasculature, the introduction of the endoscopic endonasal technique opens a new field in skull base surgery and recently represents a less invasive alternative for the surgical management of pathological lesions occupying the clival region. The purpose of this study is to demonstrate the use of the endoscopic endonasal approach as a therapeutic approach for multiple uncommon pathologies presenting in the clivus region.
This case-series study was reported from a tertiary referral hospital in Dammam, Saudi Arabia. The study reports on five cases that underwent an image-guided endoscopic endonasal approach to different clivus pathologies in the hospital.
The study included five patients that were diagnosed with five different clival pathologies, for whom the endonasal endoscopic approach was used for resection and/or biopsy. Among five patients, (80 %) were males. The age of patients ranged from 23 to 47. The mean age (±SD) was 36.6 (±8.3). Pathologies diagnosed were clivus chordoma (20 %), clivus lymphoma (20 %), metastatic cancer (20 %), invasive fungal rhinosinusitis (IFRS) clivus (20 %), and multipl myeloma (20 %).
When compared to other transcranial techniques, the image guided endoscopic endonasal approach to the clival area is safe, effective, and allows greater vision of that region. We demonstrated in this study that the endonasal approach to the clival area may be used to treat a variety of clival pathologies.
不同的病理情况可累及斜坡区。尽管斜坡区解剖位置具有挑战性且神经血管结构复杂,但鼻内镜技术的引入为颅底手术开辟了新领域,并且最近已成为治疗累及斜坡区的病理性病变的一种侵入性较小的替代方法。本研究的目的是证明鼻内镜入路可作为治疗斜坡区多种罕见病理情况的一种治疗方法。
本病例系列研究来自沙特阿拉伯达曼的一家三级转诊医院。该研究报告了在该院接受影像引导下鼻内镜入路治疗不同斜坡病变的5例病例。
该研究纳入了5例被诊断为5种不同斜坡病变的患者,采用鼻内镜入路对其进行切除和/或活检。5例患者中,(80%)为男性。患者年龄范围为23至47岁。平均年龄(±标准差)为36.6(±8.3)。诊断出的病理情况包括斜坡脊索瘤(20%)、斜坡淋巴瘤(20%)、转移性癌(20%)、侵袭性真菌性鼻窦炎(IFRS)累及斜坡(20%)和多发性骨髓瘤(20%)。
与其他经颅技术相比,影像引导下鼻内镜入路至斜坡区是安全、有效的,并且能更清晰地观察该区域。我们在本研究中证明,鼻内镜入路至斜坡区可用于治疗多种斜坡病变。