The transnasal endoscopic approach for resection of clival tumors: a single-center experience
Abstract Clival tumors present challenging entities regarding their treatment options. Due to their proximity to critical neurovascular structures, the operative goal of gross total tumor resection is rendered more difficult by a high risk of neurological deficits. Retrospective cohort study of pati...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-02-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-30216-8 |
| _version_ | 1827984305331109888 |
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| author | Vicki M. Butenschoen Philipp Krauss Denise Bernhardt Chiara Negwer Stefanie Combs Bernhard Meyer Jens Gempt |
| author_facet | Vicki M. Butenschoen Philipp Krauss Denise Bernhardt Chiara Negwer Stefanie Combs Bernhard Meyer Jens Gempt |
| author_sort | Vicki M. Butenschoen |
| collection | DOAJ |
| description | Abstract Clival tumors present challenging entities regarding their treatment options. Due to their proximity to critical neurovascular structures, the operative goal of gross total tumor resection is rendered more difficult by a high risk of neurological deficits. Retrospective cohort study of patients treated for clival neoplasms through a transnasal endoscopic approach between 2009 and 2020. Assessment of preoperative clinical status, length of operation, number of approaches, pre- and postoperative radiotherapy, and the clinical outcome. Presentation and clinical correlation with our new classification. In total, 59 transnasal endoscopic operations were performed on 42 patients over 12 years. Most lesions were clival chordomas; 63% of the lesions did not reach the brainstem. Cranial nerve impairment was present in 67% of the patients, and 75% of the patients with cranial nerve palsy improved after surgical treatment. Interrater reliability for our proposed tumor extension classification showed a substantial agreement (Cohen’s κ = 0.766). The transnasal approach was sufficient to achieve a complete tumor resection in 74% of the patients. Clival tumors exhibit heterogeneous characteristics. Depending on clival tumor extension, the transnasal endoscopic approach can present a safe surgical technique for upper and middle clival tumor resection, with a low risk of perioperative complications and a high rate of postoperative improvement. |
| first_indexed | 2024-04-09T22:57:23Z |
| format | Article |
| id | doaj.art-7db3c2b0bdcd42e891ac66db11eefd18 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-09T22:57:23Z |
| publishDate | 2023-02-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-7db3c2b0bdcd42e891ac66db11eefd182023-03-22T11:09:49ZengNature PortfolioScientific Reports2045-23222023-02-011311810.1038/s41598-023-30216-8The transnasal endoscopic approach for resection of clival tumors: a single-center experienceVicki M. Butenschoen0Philipp Krauss1Denise Bernhardt2Chiara Negwer3Stefanie Combs4Bernhard Meyer5Jens Gempt6Department of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of MunichDepartment of Neurosurgery, Faculty of Medicine, University of AugsburgDepartment of Radiation Oncology, School of Medicine, Klinikum rechts der Isar, Technical University of MunichDepartment of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of MunichDepartment of Radiation Oncology, School of Medicine, Klinikum rechts der Isar, Technical University of MunichDepartment of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of MunichDepartment of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of MunichAbstract Clival tumors present challenging entities regarding their treatment options. Due to their proximity to critical neurovascular structures, the operative goal of gross total tumor resection is rendered more difficult by a high risk of neurological deficits. Retrospective cohort study of patients treated for clival neoplasms through a transnasal endoscopic approach between 2009 and 2020. Assessment of preoperative clinical status, length of operation, number of approaches, pre- and postoperative radiotherapy, and the clinical outcome. Presentation and clinical correlation with our new classification. In total, 59 transnasal endoscopic operations were performed on 42 patients over 12 years. Most lesions were clival chordomas; 63% of the lesions did not reach the brainstem. Cranial nerve impairment was present in 67% of the patients, and 75% of the patients with cranial nerve palsy improved after surgical treatment. Interrater reliability for our proposed tumor extension classification showed a substantial agreement (Cohen’s κ = 0.766). The transnasal approach was sufficient to achieve a complete tumor resection in 74% of the patients. Clival tumors exhibit heterogeneous characteristics. Depending on clival tumor extension, the transnasal endoscopic approach can present a safe surgical technique for upper and middle clival tumor resection, with a low risk of perioperative complications and a high rate of postoperative improvement.https://doi.org/10.1038/s41598-023-30216-8 |
| spellingShingle | Vicki M. Butenschoen Philipp Krauss Denise Bernhardt Chiara Negwer Stefanie Combs Bernhard Meyer Jens Gempt The transnasal endoscopic approach for resection of clival tumors: a single-center experience Scientific Reports |
| title | The transnasal endoscopic approach for resection of clival tumors: a single-center experience |
| title_full | The transnasal endoscopic approach for resection of clival tumors: a single-center experience |
| title_fullStr | The transnasal endoscopic approach for resection of clival tumors: a single-center experience |
| title_full_unstemmed | The transnasal endoscopic approach for resection of clival tumors: a single-center experience |
| title_short | The transnasal endoscopic approach for resection of clival tumors: a single-center experience |
| title_sort | transnasal endoscopic approach for resection of clival tumors a single center experience |
| url | https://doi.org/10.1038/s41598-023-30216-8 |
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