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Anterior Transsphenoidal Coronal View with Exposure of Multiple Spaces

Surgical Correlation


Anterior transsphenoidal coronal view with exposure of multiple spaces. The body of the sphenoid has been removed to expose the pituitary gland and anterior intercavernous sinus, which communicates laterally with the cavernous sinuses on the lateral surfaces of the body of the sphenoid. The cavernous segments of the internal carotid arteries are also in view. Lateral to these are the apices of the orbits with their associated neurovasculature and muscles. The maxillary nerves have entered the pterygopalatine fossae located along the upper anterior surface of the pterygoid processes. The remaining portions of these processes have been removed to expose the tensor veli palatini muscles. The infratemporal fossae, located lateral to the pterygoid processes, show the mandibular nerve and multiple branches, including deep temporal, auriculotemporal, lingual, and inferior alveolar. The maxillary artery gives rise to deep temporal, inferior alveolar, and middle meningeal branches. A window in the clivus has been created to reveal the medulla and pons and the vertebral and basilar arteries. (Image courtesy of AL Rhoton, Jr.)