Transmaxillary and Transmandibular Approach to a C1 Chordoma

Abstract

A transmaxillary and transmandibular approach allowed us to obtain a complete view of a large immovable chordoma located ventral to the upper cervical spine. This enabled us to resect totally the tumor into 2 pieces without major complications or sequelae. This approach is useful for the resection of large tumors located in the median upper cervical spine.

Multifocal thoracic chordoma mimicking a paraganglioma

“…It is a common knowledge that no chemotherapy is proved to be effective; however, Neo et al, in 2007, proved anti-cancer activity of Imatinib -Tyrosine Kinase inhibitor. [8] Although very rare, chordoma should be suggested in the differential diagnosis of paravertebral cervical and thoracic masses of unknown origin.…”

“…[8] Although very rare, chordoma should be suggested in the differential diagnosis of paravertebral cervical and thoracic masses of unknown origin.…”

A clivus plate fixation for reconstruction of ventral defect of the craniovertebral junction: a novel fixation device for craniovertebral instability

“…In this method, dissection of the mandible and lateral deviation of the tongue allowed a maximum surgical exposure. However, infection risk is a concern, as this technique is performed through the mouth and dissection of oropharyngeal mucosa [20]. Also, the proximity of the approach to the trachea, esophagus, major vessels (vertebral and carotid arteries) and major nerves (hypoglossal, vagus, accessories) raises the risk of damage to these vital structures.…”

Cervical chordoma managed with multidisciplinary surgical approach

“…Treatment is ideally surgical but management of chordomas is technically challenging because of the requirement of wide exposure, surrounding anatomy and potential risk of neurological morbidity 17,18 …”

“…Various surgical approaches have been described in the literature to access the clivus and upper cervical spine, which include transmaxillary, transmandibular, mandibular swing, transpalatal, transoral, transcervical, high anterior cervical and lateral approach. Sometimes, combinations of approaches are used to gain adequate access for chordomas of the upper cervical spine 18–21 …”