Neurol India Close
 

Figure 1: Stepwise demonstration of trans nasal endoscopic approach to sella and pituitary gland. (a) Endoscopic view of sphenoid ostia (arrow). On left side middle turbinate is preserved to demonstrate its relationship to ostium of sphenoid sinus. On right side sphenopalatine foramen is visible at root of inferior turbinate. (b) Panoramic view of sphenoid sinus cavity after anterior sphenoidectomy showing posterior wall of sphenoid sinus with sella floor, optic protuberance, tuberculum sella, planum sphenoidale, clival recess and internal carotid artery protuberance. Clival recess can be seen bordered by paraclival internal carotid artery laterally on both sides. (c) Endoscopic view after removal of bone of posterior wall of sphenoid sinus. Underlying periosteal dura can be seen covering sella, clivus and internal carotid artery. Sellar internal carotid artery appears to form a variable C-shaped curvature when viewed from endonasal endoscopic perspective. Basilar plexus or posterior intercavernous sinus can be seen between layers of clival dura. (d) Close up view of sellar compartment with pituitary gland. Inferior hypophyseal artery can be seen on right side going to posterior pituitary gland. Anteriorly direct branch from internal carotid artery can be seen supplying capsule of pituitary gland. These branches are also known as McConnel's capsular branches. (e) Overview of endoscopic dissection of sella, clival and suprasellar region. Dura covering anterior skull base, optic nerves, pituitary gland, cavernous sinus, internal carotid arteries and clival region has been removed to expose neurovascular structures. Pituitary gland can be seen in relation to optic chiasma and suprasellar arteries. Ophthalmic arteries can be seen arising from supraclinoid internal carotid arteries and going below optic nerves. Basilar artery with brainstem is visible in the background. (f) Close up view of pituitary gland with stalk and optic chiasma. Superior hypophyseal artery can be seen arising from internal carotid artery and supplying stalk and anterior lobe of pituitary gland. Anterior communicating artery complex is visible in supra-chismatic recess

Figure 1: Stepwise demonstration of trans nasal endoscopic approach to sella and pituitary gland. (a) Endoscopic view of sphenoid ostia (arrow). On left side middle turbinate is preserved to demonstrate its relationship to ostium of sphenoid sinus. On right side sphenopalatine foramen is visible at root of inferior turbinate. (b) Panoramic view of sphenoid sinus cavity after anterior sphenoidectomy showing posterior wall of sphenoid sinus with sella floor, optic protuberance, tuberculum sella, planum sphenoidale, clival recess and internal carotid artery protuberance. Clival recess can be seen bordered by paraclival internal carotid artery laterally on both sides. (c) Endoscopic view after removal of bone of posterior wall of sphenoid sinus. Underlying periosteal dura can be seen covering sella, clivus and internal carotid artery. Sellar internal carotid artery appears to form a variable C-shaped curvature when viewed from endonasal endoscopic perspective. Basilar plexus or posterior intercavernous sinus can be seen between layers of clival dura. (d) Close up view of sellar compartment with pituitary gland. Inferior hypophyseal artery can be seen on right side going to posterior pituitary gland. Anteriorly direct branch from internal carotid artery can be seen supplying capsule of pituitary gland. These branches are also known as McConnel's capsular branches. (e) Overview of endoscopic dissection of sella, clival and suprasellar region. Dura covering anterior skull base, optic nerves, pituitary gland, cavernous sinus, internal carotid arteries and clival region has been removed to expose neurovascular structures. Pituitary gland can be seen in relation to optic chiasma and suprasellar arteries. Ophthalmic arteries can be seen arising from supraclinoid internal carotid arteries and going below optic nerves. Basilar artery with brainstem is visible in the background. (f) Close up view of pituitary gland with stalk and optic chiasma. Superior hypophyseal artery can be seen arising from internal carotid artery and supplying stalk and anterior lobe of pituitary gland. Anterior communicating artery complex is visible in supra-chismatic recess