Image guided endonasal endoscopic approach to different clivus pathologies.

: Different pathologies can affect the clivus region. Despite the challenging anatomical location and complexity of neuro-vasculature, the introduction of the endoscopic endonasal technique opens a new field in skull base surgery and recently represents a less invasive alternative for the surgical management of pathological lesions occupying the clival region. The purpose of this study is to demonstrate the use of the endoscopic endonasal approach as a therapeutic approach for multiple uncommon pathologies presenting in the clivus region.

Methods: This case-series study was reported from a tertiary referral hospital in Dammam, Saudi Arabia. The study reports on five cases that underwent an image-guided endoscopic endonasal approach to different clivus pathologies in the hospital.

Results: The study included five patients that were diagnosed with five different clival pathologies, for whom the endonasal endoscopic approach was used for resection and/or biopsy. Among five patients, (80 %) were males. The age of patients ranged from 23 to 47. The mean age (±SD) was 36.6 (±8.3). Pathologies diagnosed were clivus chordoma (20 %), clivus lymphoma (20 %), metastatic cancer (20 %), invasive fungal rhinosinusitis (IFRS) clivus (20 %), and multipl myeloma (20 %).

Conclusions: When compared to other transcranial techniques, the image guided endoscopic endonasal approach to the clival area is safe, effective, and allows greater vision of that region. We demonstrated in this study that the endonasal approach to the clival area may be used to treat a variety of clival pathologies.