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Endoscopic Middle and Lower Transclival Approach Intradural Exposure

Surgical Correlation

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Endoscopic endonasal middle and inferior transclival approach, intradural stage. The jugular tubercle has been removed to provide access to the lateral cerebellomedullary cistern and its contents: glossopharyngeal or IX, vagus or X and spinal accessory or XI nerves, posterior inferior cerebellar artery (PICA), flocculus and choroid plexus at foramen of Luschka. The lower cranial nerves (IX-X-XI) arise from the postolivarysulcus and they are located posterior to the hypoglossal nerve rootlets. (Image courtesy of JC Fernandez-Miranda)

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