Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-19T17:54:21.414Z Has data issue: false hasContentIssue false

Ecchordosis physaliphora: a cautionary tale

Published online by Cambridge University Press:  20 December 2019

C Georgalas*
Affiliation:
Department of Otolaryngology, Hygeia Hospital, Athens, Greece Head and Neck Surgery Department, University of Nicosia Medical School, Cyprus
D Terzakis
Affiliation:
Department of Otolaryngology, Hygeia Hospital, Athens, Greece
M Tsikna
Affiliation:
Department of Otolaryngology, Hygeia Hospital, Athens, Greece
Z Alatzidou
Affiliation:
Department of Otolaryngology, Hygeia Hospital, Athens, Greece
S de Santi
Affiliation:
Department of Otolaryngology, Pisa University Hospital, Italy
V Seccia
Affiliation:
Department of Otolaryngology, Pisa University Hospital, Italy
I Dallan
Affiliation:
Department of Otolaryngology, Pisa University Hospital, Italy
*
Author for correspondence: Dr Christos Georgalas, Endoscopic Sinus and Skull Base Center, Hygeia Hospital, Erythrou Stavrou 4, Maroussi15123, Greece E-mail: [email protected]

Abstract

Background

Ecchordosis physaliphora is a congenital, benign lesion originating from notochordal remnants along the craniospinal axis, most frequently located at the level of the clivus and sacrum. Sometimes ecchordosis physaliphora is difficult to recognise and treat, with a total of twenty-six cases described in the literature.

Methods

This study reports on three cases of previously undiagnosed ecchordosis physaliphora presenting with cerebrospinal fluid rhinorrhoea and meningitis.

Conclusion

Endoscopic transclival or transsphenoid surgery including three-layer (fat, fascia and nasoseptal flap) reconstruction was used in all cases with complete resolution of the symptoms.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited, 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr C Georgalas takes responsibility for the integrity of the content of the paper

References

1Dias, LA, Nakanishi, M, Mangussi-Gomes, J, Canuto, M, Takano, G, Oliveira, A. Successful endoscopic endonasal management of a transclival cerebrospinal fluid fistula secondary to ecchordosis physaliphora--an ectopic remnant of primitive notochord tissue in the clivus. Clin Neurol Neurosurg 2014;117:116–1910.1016/j.clineuro.2013.11.026CrossRefGoogle ScholarPubMed
2Lagman, C, Varshneya, K, Sarmiento, J, Turtz, AR, Chitale, RV. Proposed diagnostic criteria, classification schema, and review of literature of notochord-derived ecchordosis physaliphora. Cureus 2016;8:e547Google ScholarPubMed
3Alli, A, Clark, M, Mansell, NJ. Cerebrospinal fluid rhinorrhea secondary to ecchordosis physaliphora. Skull Base 2008;18:395–9910.1055/s-0028-1087221CrossRefGoogle ScholarPubMed
4Ferguson, C, Clarke, DB, Sinha, N, Shankar, JJ. A case study of symptomatic retroclival ecchordosis physaliphora: CT and MR Imaging. Can J Neurol Sci 2016;43:210–12Google ScholarPubMed
5Galloway, L, Hayhurst, C. Spontaneous cerebrospinal fluid rhinorrhoea with meningitis secondary to ecchordosis physaliphora. Br J Neurosurg 2019;33:9910010.1080/02688697.2017.1297766CrossRefGoogle ScholarPubMed
6Choudhri, O, Feroze, A, Hwang, P, Vogel, H, Ajlan, A, Harsh, G 4th. Endoscopic resection of a giant intradural retroclival ecchordosis physaliphora: surgical technique and literature review. World Neurosurg 2014;82:912.e21e26Google ScholarPubMed
7Park, HH, Lee, K-S, Ahn, SJ, Suh, SH, Hong, CK. Ecchordosis physaliphora: typical and atypical radiologic features. Neurosurg Rev 2017;40:879410.1007/s10143-016-0753-4CrossRefGoogle ScholarPubMed
8Bolzoni-Villaret, A, Stefini, R, Fontanella, M, Bottazzoli, M, Turri Zanoni, M, Pistochini, A et al. Transnasal endoscopic resection of symptomatic ecchordosis physaliphora. Laryngoscope 2014;124:1325–810.1002/lary.24434CrossRefGoogle ScholarPubMed