Threading the Needle: Endoscopic Resection of Clival Chordoma Involving the Carotid and Basilar Arteries

We present the case of a 70-year-old man with double vision (left CN VI palsy) leading to clival chordoma diagnosis. MRI showed an intra/extradural lesion extending beyond the left petroclival synchondrosis, stenosing the left paraclival carotid, and compressing the brainstem and basilar artery. He underwent an endoscopic transclival, transpterygoid approach with gross total resection. Key insights include using the Vidian canal as a landmark and careful dissection off the carotid and basilar artery and perforators.

Publication History

Article published online:
07 February 2025