Chordoma surgery

Chordoma is a malignancy that occurs in the spinal cord. Among the treatments for chordoma, surgery is far more effective than chemotherapy and radiation.

Chordoma is a rare, slow-growing malignancy that develops from very small remnants of articular cartilage. Spinal cord tumor develops from the remnants of the spinal cord, so it can appear at any position of the spinal axis, but is mainly distributed at two ends: the sloping surface of the scapula and the sacrum. Chordoma usually occurs in men aged 40 - 60.
Chordoma mainly develops local invasion, the rate of metastasis is quite low (5-20%) but has a very high recurrence rate ( about 85%) because it is not possible to surgically remove the entire tumor. On the other hand, the symptoms of chordoma are quite faint, easily confused with many other diseases. If the tumor develops intracranially, the common symptoms are headache, diplopia, dysphagia. If the tumor is on the spine it can cause pain in the affected area, pain in the arms or legs, and bladder or bowel disorders. Therefore, patients often miss the opportunity to detect and treat the disease early in the early stages. Most patients with myeloma are hospitalized when the tumor is large. This partly affects the ability to cure the disease and increases the risk of complications during treatment.
Currently available treatments for chordoma are surgery, radiation and chemotherapy. In which, surgery is still the main treatment method.

Thanks to the support of high-tech facilities such as nerve positioning system, microsurgery glasses, endoscope,... surgical methods of chordoma in the sphenoid sinus - skull base can be performed easily. than.

Indications: Chordoma tumor is located in the sphenoid sinus, pituitary fossa, suprapubic, and suprapubic but does not extend beyond the anterior part of the stony slope; Contraindications: In case of limited access, such as narrow sphenoid sinus.

Performers: Main surgeon, assistant surgeon, nurse, anesthesiologist team; Patients: Have a detailed examination; basic tests, endocrine tests; preoperative anesthetic examination as prescribed; wash hair clean and aerosol before surgery; Technical facilities: Equipment for endotracheal anesthesia and patient monitoring during and after surgery; operating table equipped with Mayfield head fixing system; neural positioning system, grinding drill, endoscopic and KVP system, ultrasonic suction knife; cranial microsurgery and endoscopic kits; consumables (cotton, gauze, sutures, skull wax,...); Medical records: Prepare according to regulations.

Patient position: supine, head straight, chin tilted to the right and maximal supine, head firmly fixed on the Mayfield frame; Anesthesia: Perform endotracheal anesthesia; Registering the patient's neural navigation system; Use diluted betadine to clean the patient's 2 noses. Then, put naphazoline-impregnated meche so that the nasal septum can contract well; Disinfect the surgical area and spread; Perform optic placement, push out the middle nasopharynx, find the sinus opening and use an electric knife to create a pedunculated mucosal flap to expose the anterior wall of the sphenoid sinus; Using a drill and trigger to open the sinus wall, burn the sinus mucosa and remove the chordoma that invades the sphenoid cavity; Open the saddle pit floor and check the poles under the nav; Perform dural and arachnoid openings; Use a pince to remove the tumor partially or use a drill to remove the tumor if the tumor is too hard. Pay attention when intervening in places such as pituitary stalk, internal carotid artery, basilar artery and optic interference; Stop bleeding, fill the surgical site with fat and take the fascia to create a dura. Next, restore the pituitary floor with nasal septum and bioglue injection; Covering the nasal mucosa flap to fill the incision; Re-irrigate with dilute betadine and saline serum; Put 2 meche merocel into 2 stitches, fixed. Complete the surgery.

Monitor the patient's indicators including pulse, respiration, temperature and blood pressure; Monitor the patient's consciousness, pupils and urine; Follow the nose meche.

Bleeding: Treat by re-operating to remove the hematoma and holding the device; Infection: The treatment is medical treatment (using antibiotics); Diabetes insipidus or adrenal insufficiency: Should be treated with drugs (using hormone replacement) and rehydration - electrolytes; Ventricular dilatation due to intraoperative bleeding: Treat by draining the ventricles into the abdomen or out; Cerebrospinal fluid leak: Perform lumbar puncture and re-open the fistula. Surgical treatment of chordoma is an effective method of treatment, especially when detecting tumors at an early stage. Therefore, as soon as there are warning signs of a live tumor, patients should go to the doctor for early diagnosis and effective and active treatment methods.
Vinmec International General Hospital with a system of modern facilities, medical equipment and a team of experts and doctors with many years of experience in neurological examination and treatment, patients can completely peace of mind for examination and treatment at the Hospital.
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