From the Occipital Condyle to the Sphenoid Sinus: Extradural Extension of the Far Lateral Transcondylar Approach with Endoscopic Assistance

摘要

BACKGROUND: Surgical management of extensive skull base tumors, such as chordoma and chondrosarcoma, remains very challenging. The need for gross total removal to improve survival must be weighed against the risk of injury to neurovascular structures and the loss of stability at the craniovertebral junction. In cases of tumors that are already compromising craniovertebral junction stability, the occipital condyle can be exploited as a deep keyhole to reach the clivus, petrous apex, and sphenoid sinus.