Clinical Analysis Of Surgical Therapy Of Five Clivus Chordoma By Far Lateral Approach

Objective The chordoma is the remnant tissue of the embryo organizing which is a kind of rarer destructive tumour.The morbidity age is 30～40-year-old between.The male incidence rate is greater than the female.The skull inner chordoma often originate from the center line of the slope,may grow to the vicinity.Owing to the position of the chordoma is very profunda,the demand of the surgical therapy is very strict for the exposure of surgery,the handing of the vertebral artery and nerve root in the skill,can expand the visual fields of surgery by stripping condylus occipitalis and the atlas lateral mass.The merit of the far lateral approach can be sufficient when the tumour is especially bigger,embody.The condylus occipitalis length is 30 +/- 4 millimeters about,when we grind away the condylus occipitalis every 1 millimeter,we can expand the visual fields to abdomen,approximately 2.4°,grind off the condylus occipitalis 1/3,may enhance a visual fields 15.9°,Grind except 1/2 but enhance 19.9°.Because of the the visual fields of the surgery is wild,the scope of the grinding condylus occipitalis can be zoomed out,when the anteroposterior diameter is long,the brain stem be justled to the dorsal.On the contrary, the scope of the grinding condylus occipitalis should be expand.Thereby protect nerve and bilateral vertebral artery in the surgery area much better. To explore a surgical approach to chordoma by farlateral suboccipital approach.Methods Retrospective analysis six patients with chordoma were operated through the far-lateral suboccipital approach from September. 2000 to October.2009.And analysis the merit and demerit of the surgical approach as well as surgical highlight. Results Among the six patients,total removal of tumor was achieved in 3 cases,subtotal removal of tmnor in 1 cases and biopsy in 1 case.No surgical mortality occurred in this series.Conclusion this approach can provide large field of operation and wide surgical exposure to the lesion,and benefit minimalrem～etation of brain stem and main blood vessls or cranial nerves.