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Endoscopic Views of Sellar Region

Surgical Correlation

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A, Endoscopic view of sphenoid sinus. The carotid prominences are seen lateral to the anterior wall of the sella. The anterior sellar wall has been opened to expose the dura lining the anterior wall of the sella. B, The dura lining the sella and covering the intracavernous carotids and the cavernous sinuses has been removed. The pituitary stalk is exposed above the gland. C, View with the 30-degree-angle endoscope. The optic strut, which separates the optic canal and the superior orbital fissure, has been removed. The opticocarotid recess, which has been opened, extends into the strut. The cavernous sinus surrounds the intracavernous carotid. D, The venous material in the cavernous sinus has been cleared to expose the nerves coursing in the walls of the cavernous sinus. The abducens nerve courses on the medial side of the ophthalmic nerve. The maxillary nerve is in the lower margin of the exposure. The inferolateral trunk arises from the cavernous carotid artery and passes between the abducens and ophthalmic nerves. E, Enlarged view of the inferior hypophyseal artery passing from the intracavernous carotid to the posterior lobe. F, The tuberculum and planum sphenoidale have been removed to expose the optic nerves and chiasm and the pituitary stalk. In addition, the clivus and the clival dura have been opened to expose the basilar artery and pons below the gland. (Images courtesy of AL Rhoton, Jr.)

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