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Abstract：
Introduction Surgical treatment of petrous apex chondrosarcoma is challenging due to the location of the tumor. Using an endoscopic technique for tumor resection is favored since it provides a minimally invasive approach. Case Presentation A 57 years old female was admitted for acute onset of left abducens nerve palsy and occasional headache mainly on the left side of the retro-orbital area with some radiation to the left occiput. Magnetic resonance imaging (MRI) and computed tomography (CT), at the time of admission, were showed lytic lesion on the left petrous apex and left part of the clivus. Results of metastatic workup were negative. The surgical procedure considered was expanded endoscopic endonasal transclival approach to the left of the petrous apex and reconstruction with a pedicled nasoseptal flap with image guidance system. The pathology confirmed chondrosarcoma on myxoid background. The surgical procedure was uncomplicated. The abducens nerve palsy was resolved in few weeks and no new deficits occurred. Postoperative MRI showed complete resection of the tumor. Conclusion Expanded endoscopic endonasal transclival approach to petrous apex and reconstruction appears to be safe and feasible technique, capable of achieving total removal of identified lesions near the petrous apex. Nonetheless, future studies with a greater number of patients are crucial to confirm and consolidate this initial impression.
摘要：
介绍由于肿瘤的位置，岩尖软骨肉瘤的手术治疗具有挑战性。使用内窥镜技术进行肿瘤切除是有利的,因为它提供了微创方法。病例介绍一名57岁的女性因急性发作左外展神经麻痹和偶尔头痛而入院，主要发生在眶后区域的左侧，并对左枕骨进行了一些辐射。磁共振成像（MRI）和计算机断层扫描（CT），在录取的时候，在左侧岩尖和斜坡的左侧部分显示溶解性病变。转移检查结果为阴性。考虑的手术方法是将内窥镜经鼻后入路扩大到岩尖的左侧，并用带有图像引导系统的带蒂鼻中隔皮瓣进行重建。病理证实软骨肉瘤为粘液样背景。手术程序并不复杂。外展神经麻痹在几周内得到解决，没有出现新的缺陷。术后MRI显示肿瘤完全切除。结论扩大内镜下经鼻板入路岩尖重建是安全可行的。能够完全去除岩尖附近的确定病变。尽管如此，未来对更多患者进行的研究对于确认和巩固这种初步印象至关重要.
