Atypical clinical and pathological features of a cranio-cervical chordomas have prompted a review of these neoplasms at the University of Michigan Medical Center. Contrary to prior investigations, 92% of the spheno-occipital chordomas reported in this study clinically presented with a nasopharyngeal or intranasal mass. This high incidence indicates the requirement for an otorhinologic examination on all patients presenting with the neuro-ophthalmologic syndrome and roentgenologic findings characteristic of chordomas in this anatomical region. Special attenion is called to a histologically distinctive variant of chordoma - the "chondroid chordoma.' Apparently restricted to the cranio-cervical region, this variant has been associated with long survival.
The management of frontal sinus injury from trauma or operation has been controversial. Case reports and extensive literature review emphasize the importance of careful treatment of the frontal sinus whenever it is violated. The principles of management are reviewed.
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