Satoka Shidoh, Masahiro Toda, Hideo Nakajima, Toshiki Tomita, Kaoru Ogawa, Takeshi Kawase and Kazunari Yoshida
Chordomas are tumors arising from notochord remnants, which are often located in midline skull base structures
such as the clivus. The location of the tumor can extend to the craniocervical junction, which can increase the difficulty
in reaching the tumor. The recently developed endonasal endoscopic approach has allows access to the entire
ventral skull base lesion directly. However, it is still difficult to access lesions around the craniovertebral junction. The
transoral-transpalatal approach allows a surgical field up to the upper clivus by removing the hard palate down to the
C3 level. Although the endonasal endoscopic approach is a useful surgical technique for clival lesions, we should
consider using the transoral/transoral-transpalatal approach for lesions between the craniovertebral junction and the
C3 level.