Abstract:Chordoma is a congenital lowgrade malignant tumor originating from residual chordal tissue during embryonic development, which mostly occurs in sacrococcygeal region and midline of skull base, especially in clivus region. The prognosis of chordoma is closely related to the degree of tumor resection. Most patients with complete resection of the tumor can survive for a long time. Because most of skull base chordomas are infiltrative and invasive, involving important nerves, blood vessels and brain tissue in the skull base, complete resection is extremely difficult. So chordoma in skull base is considered to be one of neurosurgical challenges. In recent years, with the development of neuroendoscopy technology and the wide application of intraoperative monitoring techniques such as neuronavigation system, intraoperative electrophysiological monitoring, intraoperative transnasal ultrasound system and doppler ultrasound blood vessel detector, transnasal endoscopic approach can safely resect skull base chordoma under direct vision and retain important neurovascular function as far as possible, with minimal surgical trauma and postoperative complications. The incidence of complications such as cerebrospinal fluid leakage is low, and the quality of life of patients has been significantly improved. Transnasal endoscopic approach has become the preferred method for surgical treatment of skull base chordoma. In order to further understand the efficacy, advantages and disadvantages of transnasal endoscopic surgery for skull base chordoma, we reviewed the published literature on transnasal endoscopic surgery for skull base chordoma in recent years and discussed the treatment of skull base chordoma by transnasal endoscopic surgery from the aspects of preoperative evaluation and classification of tumors, surgical strategies, degree and influencing factors of resection of tumors, and postoperative complications.
