Objective To explore the application of transsphenoidal sinus endoscopic approach in clival area chordoma. Methods From Aug. 2004 to Oct. 2011,7 cases of clival area chordoma were subjected to surgical operation via the transsphenoidal sinus endoscopic approach. One case received re-operation due to recurrence. Tumors were located in the saddle area and superior-middle clivus,or their principal parts in the superior-middle clivus and obviously extruded towards the ethmoid and the lower wall of the orbit in 2 cases,or grew diffusely. Results Tumor was totally resected under the endoscopy in 4 cases, subtotally in 2,and partially in 1. Clinical symptoms of 6 cases were relieved after operation,and one case had no obvious remission. All the patients were given postoperative radiotherapy. Postoperative follow-up period was 3 months to 4 years. One case recurred 2 years after operation and received re-operation in our hospital,and now survived with tumor. One case recurred, received re-operation in outside hospital, and lost follow-up. One case with no obvious remission after operation now survived with tumor. The remaining patients had no tumor recurrence. Conclusion The structures of clival area can be observed well under the endoscopy via the transsphenoidal approach. The endoscopic surgery via the transsphenoidal approach to the clivus is proper for the treatment of the chordoma in the clival area.%目的 探讨经鼻蝶内镜外科技术在斜坡区脊索瘤治疗中的应用.方法 2004年8月至2011年10月对7例颅底斜坡区脊索瘤患者行经鼻蝶内镜手术共8次,其中1例因复发行2次手术,1例是复发病例.肿瘤位于中上斜坡及鞍区,或主体位于中上斜坡但向筛窦及眶内下壁明显突出,或呈广泛生长.7例患者均采用经鼻蝶内镜下切除肿瘤.结果 经鼻蝶内镜下全切肿瘤4例,次全切除2例,大部分切除1例.术后临床症状得到不同程度改善6例,无明显缓解1例.术后辅助放疗.随访3个月至4年,1例术后2年复发,再次手术,目前带瘤生存；1例复发外院再次手术后失随访；术后症状无明显缓解的1例病例,目前带瘤生存,一般情况较差；其余患者肿瘤无复发.结论 经鼻蝶内镜治疗斜坡脊索瘤可以更好地辩认深部结构,可以更近距离到达斜坡区,是斜坡脊索瘤治疗的一种较好的手术入路.
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