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ISSN 2007-3178 (Print)
Asociación Mexicana de Cirugía Bucal y Maxilofacial, Colegio Mexicano de Cirugía Bucal y Maxilofacial, A.C.

2018, Number 3

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Rev Mex Cir Bucal Maxilofac 2018; 14 (3)

Osteotomía tipo Le Fort I para resección de cordoma de clivus

García SJM, López-Villa EE, López BS

Language: Spanish
References: 31
Page: 146-156
PDF size: 382.38 Kb.


ABSTRACT

Chordomas are rare, slow-growing, aggressive course neoplasms originating from notochord remains. They are located in the center of the base of the skull, present different patterns of extension in all directions including infiltration of the dura mater and covering of the neurovascular structures, which limits the extension for the removal of the neoplasm. Their evolution is unpredictable, some grow rapidly despite treatment and are associated with poor prognosis, while others have a benign course. There are several approaches to clivus, which aim to avoid nerves and brain retraction. Previous extracranial procedures include the transnasal, transsphenoidal, transmaxillary and transoral approaches. Treatment of skull base chordomas remains a challenge for the surgeon. The recurrence rate, even after radical surgical removal, remains high, the median survival for patients with untreated chordomas is 28 months after onset of symptoms, survival after surgery, radiation therapy, or both is 3.6 to 6.6 years. On average, recurrence occurs two to three years after primary treatment; early recurrence is observed one month after surgical removal. Tumor recurrence is the leading cause of death, recurrence-free survival rate is an important indicator of successful treatment.


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