Endoscopic Transnasal Approach to Clival Lesions

Introduction: Clival lesions are among the most challenging skull base pathologies. Approaches are usually highly invasive and labored. These include the subfrontal transbasal, transfacial, midface degloving, and lateral transtemporal approaches. We report our experience with a minimally invasive transnasal endoscopic approach to clival lesions.

Material and Methods: Three patients underwent our new procedure from September 2003 to December 2004. Two patients had chordoma and one had carcinoma. A bi-nostril purely endoscopic technique was used. The nasal septum was detached posteriorly and the clivus exposed. Near-total excision was achieved for all cases.

Results: All patients recovered quickly from their surgery and were able to eat, walk, talk, and resume their usual activities the same evening. There were no visible scars or complications from the approach.

Conclusions: The transnasal endoscopic approach is a viable minimally invasive alternative for resection of clival lesions.