Abstract
The transsphenoidal approach was originally developed as a primary extradural approach for the removal of pituitary neoplasms. The historical aspects were previously discussed (see p. 274). Later this approach came to be used for the removal of clivus tumors (Decker and Malis 1970; Derome 1979; Hardy 1977; Rougerie et al. 1967). Transsphenoidal exposure of the clivus is indicated for tumors that involve the clivus as well as the adjacent paranasal sinuses and pharynx. The superior limit of this approach is the diaphragma sellae, and the inferior limit is the foramen magnum. Dissection can be carried laterally as far as the bony limit of the middle skull base (carotid canal, petrous apex, etc.). Besides pituitary tumors, interosseous meningiomas, fibrous dysplasia, and other bone tumors can be approached through this route.
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Samii, M., Draf, W., Lang, J. (1989). General Operative Techniques. In: Surgery of the Skull Base. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-73061-0_37
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DOI: https://doi.org/10.1007/978-3-642-73061-0_37
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