Application of personalized endoscopic techniques in surgery of endonasal resection of petroclival lesions

Background The petroclival area is located deep at the base of the skull, and the surrounding anatomical structure is complex, which brings great challenges to the safe removal of the lesions in this part of the operation. At present, the main surgical approaches for petroclival lesions are lateral craniotomy and endoscopic endonasal approach. This study explored the effectiveness and safety of endoscopic techniques in the resection of petroclival lesions via endonasal approach. Methods A total of 6 patients with petroclival lesions treated in The First Affiliated Hospital of Fujian Medical University from January 2018 to December 2020 were included. All patients underwent neuronavigation assisted endoscopic endosnasal approach resection of petroclival lesions. Results All the 6 patients successfully completed the operation. The average operation time was 4.53 h. After the operation, 3 cases were pathologically confirmed as chondrosarcoma (2 cases of WHO grade 2, one case of WHO grade 1), one case of schwannoma, one case of chordoma and one case of cholesterol granuloma. Except for one case of preoperative double vision that did not relieve postoperatively, the remaining 5 cases had preoperative symptoms alleviated to varying degrees. The average postoperative hospital stay was 5.67 d. The postoperative median follow⁃up was 14.07 months. There were no complications such as cerebrospinal fluid leakage, central nervous system infection, cranial nerve damage, no unplanned secondary operations, and no deaths within 3 months after the operation. Up to the last follow ⁃ up, no patients had recurrence. Conclusions Neuronavigation assisted endoscopic endonasal approach resection of petroclival lesions is relatively safe and effective. Different endoscopic techniques should be selected according to the tumor location and size.