Pyrgakis Panagiotis, Papargyriou Georgia Evangelia, Oostra Amanda, Chatzinakis Vasilleios, Leventi Argyro, Geramas Ioannis, Georgalas Christos
ENT Departement, Athens General Hospital Evangelismos, Athens, Greece.
Department of Head and Neck and Endoscopic Skull Base Surgery Athens, Hygeia Hospital, Marousi, Athens, Greece.
Acta Otorhinolaryngol Ital. 2025 Aug;45(4):252-260. doi: 10.14639/0392-100X-N3039.
Ecchordosis physaliphora (EP) is a benign hamartomatous lesion, most commonly found in a retroclival position, as an incidental radiological finding. EP may become symptomatic, by creating a clival defect, leading to CSF leak and meningitis, thus requiring surgical treatment.
Retrospective case series.
We present 5 cases of retroclival EP (4 males, 1 female; age range, 34-81 years) presenting in our department over the last 6 years. Four patients presented with CSF leak; 3 also had a history of bacterial meningitis, while one was diagnosed with meningitis on presentation. One patient was and remains asymptomatic 28 months later with the lesion being an incidental finding. The EP was treated in all 4 symptomatic patients with removal of the lesion and reconstruction of the defect with an endoscopic endonasal transclival approach (EETTA). All 4 patients remain free of symptoms while the lesion has not recurred for 81, 72, 52, and 22 months, respectively.
A review of the literature depicts that there is a shift from transcranial approaches to the EETTA for treating retroclival EP. The present case series highlights that EETTA facilitates the complete excision of EP lesions, as well the reconstruction of the resulting defects, with minimal morbidity and hospitalisation.
泡状脊索瘤（EP）是一种良性错构瘤性病变，最常见于斜坡后位，多为偶然的影像学发现。EP可能出现症状，造成斜坡缺损，导致脑脊液漏和脑膜炎，因此需要手术治疗。
回顾性病例系列研究。
我们呈现了过去6年中在我科就诊的5例斜坡后位EP患者（4例男性，1例女性；年龄范围34 - 81岁）。4例患者出现脑脊液漏；3例有细菌性脑膜炎病史，1例在就诊时被诊断为脑膜炎。1例患者在28个月后仍无症状，该病变为偶然发现。所有4例有症状的患者均采用经鼻内镜经斜坡入路（EETTA）切除病变并修复缺损进行治疗。所有4例患者均无症状，病变分别在81、72、52和22个月后未复发。
文献回顾表明，治疗斜坡后位EP的方法已从经颅入路转向EETTA。本病例系列强调，EETTA有助于完整切除EP病变以及修复由此产生的缺损，且发病率和住院时间降至最低。
