{"id":"6dff53d6-da17-4921-a2e1-c81bb505b906","slug":"targeted-chopstick-mononostril-approach-for-a-lower-clivus-chordoma","title":"Targeted chopstick mononostril approach for a lower clivus chordoma","authors":["Tancredo Alcântara","Jerold Justo","Tingting Jiang","Rosaria Abbritti","Thibault Passeri","Sébastien Froelich"],"abstract":"Background: Chordomas are rare, aggressive tumors often located at the craniovertebral junction. Endoscopic approaches are increasingly used for their treatment. Case Description: We present a case of a patient with a chordoma at the craniovertebral junction treated through a mononostril endoscopic approach, enabling total resection with minimal nasal morbidity. The technique minimized nasal structure manipulation and avoided complications such as cerebrospinal fluid leaks. The nasopharyngeal mucosa was carefully sutured at the end of the procedure, further reducing postoperative nasal morbidity. Conclusion: The endoscopic “chopstick” approach, with mucosal suturing, offers reduced nasal morbidity and favorable recovery in craniovertebral junction chordomas. 1) 0:00 – Clinical Presentation 2) 0:18 – Neuroimaging Findings 3) 0:48 – Rationale for the Procedure 4) 1:10 – Risks of the Procedure 5) 1:40 – Potential Benefits 6) 2:05 – Alternative Approaches 7) 2:48 – Description of the Setup 8) 3:10 – Key Surgical Steps 9) 4:19 – Intradural Stage 10) 5:47 – Mucosal suture 11) 6:49 – Disease Background 12) 7:16 – Clinical and Imaging Outcome. Institutional Review Board approval is not required. The authors certify that they have obtained all appropriate patient consent. There are no conflicts of interest. The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI. https://doi.org/10.25259/SNI_1117_2024 The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Journal or its management. The information contained in this article should not be considered to be medical advice; patients should consult their own physicians for advice as to their specific medical needs.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/placeholders/specialty/skull-base.png","publishDate":"2025-03-28T00:00:00.000Z","doi":"10.25259/SNI_1117_2024","categories":["Skull Base","Video Abstract"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/6dff53d6-da17-4921-a2e1-c81bb505b906/pdf"}