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Corridor surgery: the current paradigm for skull base surgery

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Abstract

Introduction

Clival chordomas are rare tumors, especially in the pediatric population. In this report, we present the case of a 3-year-old boy who was found to have a large posterior pharyngeal, clival, and posterior fossa tumor detected on a CT scan after a closed head injury.

Discussion

Further questioning revealed a history of ataxia and dysphagia. Imaging confirmed severe extrinsic brain stem compression. The tumor was resected in multiple stages utilizing a minimally invasive endoscopic endonasal technique along with open transfacetal, transcondylar approach through the carotid–vertebral window. The child suffered no permanent complications as a result of our treatment and his dysphagia significantly improved. Although a complete resection was not feasible due to vascular encasement by the tumor, extensive decompression was obtained with minimal morbidity.

Conclusion

We present this case to illustrate a new paradigm of skull base surgical approaches for large clival lesions in pediatric patients that allows aggressive resection with minimal morbidity.

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Authors and Affiliations

  1. Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Stephen M. Pirris, Ian F. Pollack, Richard M. Spiro, Elizabeth Tyler-Kabara & Amin B. Kassam

  2. Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Carl H. Snyderman & Ricardo L. Carrau

  3. Department of Neurological Surgery, University of Pittsburgh Medical Center, 200 Lothrop Street PUH B-400, Pittsburgh, PA, 15213, USA

    Ricardo L. Carrau & Amin B. Kassam

Authors
  1. Stephen M. Pirris
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  2. Ian F. Pollack
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  3. Carl H. Snyderman
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  4. Ricardo L. Carrau
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  5. Richard M. Spiro
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  6. Elizabeth Tyler-Kabara
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  7. Amin B. Kassam
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Corresponding author

Correspondence to Amin B. Kassam.

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Pirris, S.M., Pollack, I.F., Snyderman, C.H. et al. Corridor surgery: the current paradigm for skull base surgery. Childs Nerv Syst 23, 377–384 (2007). https://doi.org/10.1007/s00381-006-0281-6

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  • DOI: https://doi.org/10.1007/s00381-006-0281-6

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