Time to Modify Rather than Discard the Transoral Approach to Selected Cases of Clival Chordomas at the Craniocervical Junction

Abstract Maintaining the transoral approach in the armamentarium of surgical approaches to clival chordomas mainly as a complimentary procedure to endonasal endoscopic approach in selected cases is advantageous. Lateral extension of the disease is a limitation to both approaches and is addressed by transcranial approaches. Especially for extensive lesions the simultaneous combination of approaches is based upon the predicted blind spots for each approach and certain technical nuances need to be considered.