Surgical treatment for atlantoaxial chordoma via endoscopic intraoral approach(Report of 6 cases)

Objective To explore the feasibility of surgical treatment for atlantoaxial chordoma via endoscopic intraoral approach.Methods Six patients with atlantoaxial chordoma were surgically treated via endoscopic intraoral approach from Nov 2004 to Jan 2007.Four of them were recurrent cases.Headache presented in all patients,nasal obstruction in 4,stretching tongue deviation in 2,lingual muscle atrophy in 1.Follow-up periods ranged from 5 to 30 months.Results Total removal was achieved in all patients.No such complications as subarachnoid hemorrhage,cerebrospinal fluid rhinorrhea,nerve injury,and meningitis occurred.By the last follow-up,no patients recurred.Conclusion Atlantoaxial chordoma can be well exposed and thoroughly resected through endoscopic intraoral approach.This surgical procedure has advantages of minimal invasion,short operation time,and rapid recovery.It is necessary to perform cervico-occipital fusion 1 or 2 weeks before operation for patients with serious destruction of cervical vertebra(C1~C3).