3D Models Related Images

Relationships in the Transbasal and Extended Frontal Approaches

Surgical Correlation


G, The septa within the sphenoid sinus, the sellar floor, and the lateral sinus wall have been removed to expose the intracavernous carotid, pituitary gland, and optic canal. H, The clivus has been opened to expose the dura facing the brainstem. The basilar sinus, which interconnects the posterior parts of the cavernous sinus, is situated between the layers of dura on the upper clivus. I, The exposure has been extended laterally by opening the medial and posterior wall of the maxillary sinus to expose the branches of the maxillary nerve and artery in the pterygopalatine fossa, located behind the posterior maxillary wall. The posterior wall of the pterygopalatine fossa is formed by the pterygoid process. The maxillary nerve enters the pterygopalatine fossa where it gives rise to the infraorbital nerve, which courses along the floor of the orbit and to the palatine nerves, which descend to the palatal area. The eustachian tube opens into the nasopharynx by passing along the posterior edge of the medial pterygoid plate. The lateral wing of the sphenoid sinus extends laterally below the maxillary nerve. J, The frontal dura has been opened and the frontal lobes elevated to expose the olfactory and optic nerves and the internal carotid and anterior and middle cerebral arteries. (Images courtesy of AL Rhoton, Jr.)