A Surgical Approach to Chordomas at the Base of the Skull

Chordoma of the skull base has a poor prognosis because of the proximity of vital structures as well as the difficulty encountered in attempting complete surgical excision. This paper presents a case of massive recurrent chordoma involving the intracranial cavity, nasal cavity, and maxillary antrum. The tumor was debulked and decompressed via a transantral approach to the pterygomaxillary fossa and the base of the skull. This technique is recommended because it achieves immediate decompression and provides a space into which the inevitable regrowth of the tumor may extend.