| Case-2
A 36 year old
male developed double vision on looking towards the left side. He
was found to have a (L) VI nerve palsy. CT and MRI showing a SOL
destroying the petrous apex and clivus. The petroclival lesion was
exposed using a transcochlear approach after posteriorly rerouting
the facial nerve. Histologic diagnosis was chordoma. The tumour
was completely removed. He received post operative radio therapy.
For lesions
of lower clivus extending through the foramen magnum, an extreme
lateral approach is ideal. This combines retrosigmoid craniectomy
(which is extented inferiorly and lateraly to open up the foramen
magnum) with removal of part of the occipital condyle and mobilization
of the vertebral artery (after opening the foramen transversorium)
and laminectomy of C1 vertebra.
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