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Endoscopic Endonasal Approach to the Clivus

Surgical Correlation


Endoscopic endonasal inferior transclival approach, step-by-step dissection. Superior-to-inferior view as provided by a 45 degree endoscope. The maxillary crest has been drilled flushed with the hard palate. The soft palate can now be identified behind the hard palate. The relevant surface anatomy of the nasopharynx is well visualized: torus tubarius, salpingo-pharyngeal fold, levator fold (levator veli palatini), salpingo-palatine fold, Eustachian tube orifice (ostium pharyngeum), and fossa of Rosenmuller. (Image courtesy of JC Fernandez-Miranda)