Chordoma is a rare primary bone tumor derived from transformed notochord remnants. It has a local aggressive behavior and high recurrence rates. Treatment of skull base chordomas is complex and challenging. Control of the disease relies mainly on surgical excision of the tumor, sometimes followed by high-dose radiation therapy. The main surgical goal is to achieve maximal tumor removal with minimal morbidity. Development of the expanded endoscopic endonasal approach has improved surgical and prognostic results of skull base chordomas. This article highlights important aspects of approach selection, technique, and nuances of surgical management of this tumor.
Key points
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The expanded endoscopic endonasal approach has revolutionized the management of ventral skull base tumors.
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Skull base chordomas are prone to endoscopic resection because of their midline location.
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Approach selection, technique, and nuances of the surgical management of skull base chordomas are discussed.