Risk factors early warning system of endoscopic skull base surgery in trans-nasal skull base chordoma surgery

Abstract

Objective To discuss the value and significance of risk factors early warning system of endoscopic skull base surgery (RFEWS) in the trans-nasal skull base chordoma surgery.Methods RFEWS was comprised of neuronavigation,intra-operative neurophysiologic monitoring equipments,intra-operative ultrasound and Doppler probe.The application of RFEWS in 48 chordoma patients who received endoscopic trans-nasal surgery was analyzed.RFEWS was used to recognize the intra -operation risk factors consisting of the crucial blood vessels or nerves damage and tumor residual.Results RFEWScould recognize and protect skull base main arteries in 16 cases,cranial nerves in 5,brain stems in 2 and guide residual tumor resection in 4.The total,subtotal and partial resection were performed in 11,25 and 12 patient respectively.After a follow-up of 48 patients for 12-18 months,2 patients were recurrent,there was no other severe complication.Conclusion Using RFEWS in skull base chordoma surgery was in favor of recognizing and locating important vessels and tissues and was helpful to raise the operation safety and excision rates. Key words: Neuro-endoscopy; Trans-nose; Chordoma; Risk factors ; Warning system