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Case report: Side-firing intraoperative ultrasound guided endoscopic endonasal resection of a clival chordoma

Clival chordomas are locally invasive midline skull base tumors arising from remnants of the primitive notochord. Intracranial vasculature and cranial nerve involvement of tumors in the paraclival region necessitates image guidance that provides accurate real-time feedback during resection. Several...

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Autores principales: Baker, Katherine E., Robbins, Austin C., Kumm, Zeynep T., Ziemke, Michael K., Washington, Chad W., Luzardo, Gustavo D., Taylor, Charlotte S., Stringer, Scott P., Zachariah, Marcus A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10014906/
https://www.ncbi.nlm.nih.gov/pubmed/36937453
http://dx.doi.org/10.3389/fonc.2023.1039159
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author Baker, Katherine E.
Robbins, Austin C.
Kumm, Zeynep T.
Ziemke, Michael K.
Washington, Chad W.
Luzardo, Gustavo D.
Taylor, Charlotte S.
Stringer, Scott P.
Zachariah, Marcus A.
author_facet Baker, Katherine E.
Robbins, Austin C.
Kumm, Zeynep T.
Ziemke, Michael K.
Washington, Chad W.
Luzardo, Gustavo D.
Taylor, Charlotte S.
Stringer, Scott P.
Zachariah, Marcus A.
author_sort Baker, Katherine E.
collection PubMed
description Clival chordomas are locally invasive midline skull base tumors arising from remnants of the primitive notochord. Intracranial vasculature and cranial nerve involvement of tumors in the paraclival region necessitates image guidance that provides accurate real-time feedback during resection. Several intraoperative image guidance modalities have been introduced as adjuncts to endoscopic endonasal surgery, including stereotactic neuronavigation, intraoperative ultrasound, intraoperative MRI, and intraoperative CT. Gross total resection of chordomas is associated with a lower recurrence rate; therefore, intraoperative imaging may improve long-term outcomes by enhancing the extent of resection. However, among these options, effectiveness and accessibility vary between institutions. We previously published the first use of an end-firing probe in the resection of a clival chordoma. End-firing probes provide a single field of view, primarily limited to depth estimation. In this case report, we discuss the benefits of employing a novel minimally invasive side-firing ultrasound probe as a cost-effective and time-efficient option to navigate the anatomy of the paraclival region and guide endoscopic endonasal resection of a large complex clival chordoma.
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spelling pubmed-100149062023-03-16 Case report: Side-firing intraoperative ultrasound guided endoscopic endonasal resection of a clival chordoma Baker, Katherine E. Robbins, Austin C. Kumm, Zeynep T. Ziemke, Michael K. Washington, Chad W. Luzardo, Gustavo D. Taylor, Charlotte S. Stringer, Scott P. Zachariah, Marcus A. Front Oncol Oncology Clival chordomas are locally invasive midline skull base tumors arising from remnants of the primitive notochord. Intracranial vasculature and cranial nerve involvement of tumors in the paraclival region necessitates image guidance that provides accurate real-time feedback during resection. Several intraoperative image guidance modalities have been introduced as adjuncts to endoscopic endonasal surgery, including stereotactic neuronavigation, intraoperative ultrasound, intraoperative MRI, and intraoperative CT. Gross total resection of chordomas is associated with a lower recurrence rate; therefore, intraoperative imaging may improve long-term outcomes by enhancing the extent of resection. However, among these options, effectiveness and accessibility vary between institutions. We previously published the first use of an end-firing probe in the resection of a clival chordoma. End-firing probes provide a single field of view, primarily limited to depth estimation. In this case report, we discuss the benefits of employing a novel minimally invasive side-firing ultrasound probe as a cost-effective and time-efficient option to navigate the anatomy of the paraclival region and guide endoscopic endonasal resection of a large complex clival chordoma. Frontiers Media S.A. 2023-03-01 /pmc/articles/PMC10014906/ /pubmed/36937453 http://dx.doi.org/10.3389/fonc.2023.1039159 Text en Copyright © 2023 Baker, Robbins, Kumm, Ziemke, Washington, Luzardo, Taylor, Stringer and Zachariah https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Baker, Katherine E.
Robbins, Austin C.
Kumm, Zeynep T.
Ziemke, Michael K.
Washington, Chad W.
Luzardo, Gustavo D.
Taylor, Charlotte S.
Stringer, Scott P.
Zachariah, Marcus A.
Case report: Side-firing intraoperative ultrasound guided endoscopic endonasal resection of a clival chordoma
title Case report: Side-firing intraoperative ultrasound guided endoscopic endonasal resection of a clival chordoma
title_full Case report: Side-firing intraoperative ultrasound guided endoscopic endonasal resection of a clival chordoma
title_fullStr Case report: Side-firing intraoperative ultrasound guided endoscopic endonasal resection of a clival chordoma
title_full_unstemmed Case report: Side-firing intraoperative ultrasound guided endoscopic endonasal resection of a clival chordoma
title_short Case report: Side-firing intraoperative ultrasound guided endoscopic endonasal resection of a clival chordoma
title_sort case report: side-firing intraoperative ultrasound guided endoscopic endonasal resection of a clival chordoma
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10014906/
https://www.ncbi.nlm.nih.gov/pubmed/36937453
http://dx.doi.org/10.3389/fonc.2023.1039159
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