Right transpterygoid sublacerum approach to the petrous apex. The sellar and clival dura have been exposed and the ICA has been skeletonized from the clinoidal to the lacerum segment. The foramen lacerum has been completely exposed using the vidian nerve and pterygosphenoidal fissure as landmarks. The prominence of V2 has been exposed along the inferior-most aspect of the middle fossa. The mandibular strut separates vidian nerve and foramen lacerum from the foramen ovale and serves as a reliable landmark to identify V3. (Image courtesy of JC Fernandez-Miranda)