Türk Nöroşirürji Dergisi 2020 , Vol 30 , Num 1
Endoscopic Anatomy of the Upper and Midclival Regions
Hakan KINA1,Necmettin TANRIÖVER2
1İstinye Üniversite Hastanesi, Medical Park Gaziosmanpaşa, Nöroşirürji Bölümü, İstanbul, Türkiye
2İstanbul Üniversitesi, Cerrahpaşa Tıp Fakültesi, Nöroşirürji Anabilim Dalı, İstanbul, Türkiye
In neurosurgical practice, the clival region is located in the ventral midline, at the anterior-inferior border of the posterior fossa and extends from the basio-occiput to the upper sphenoid and ends in the dorsum sella. The upper part of the clivus consists of sphenoid bone and the lower part consists of occipital bone. The length of the clivus varies between 4 and 5 cm. Its width is 11 mm at the narrowest part. With the clivus, the petrous part of each temporal bone forms a petro-occipital fissure. This fissure expands in the postero-inferior direction and forms a jugular foramen. The clivus is separated into the upper, middle and lower clival regions from the surgical point of view. Upper Clivus is the upper 1/3 or "sellar" clivus and located above the petrous apex, above the crossing point of the abducens and trigeminal nerve posterior to the middle cranial fossa. Middle Clivus or the "sphenoidal" clivus is the region extending from the base of the sella to the coana. In particular, it has been shown that endoscopic endonasal techniques described in the last two decades allow anterior access to the clivus and craniocervical junction. Anahtar Kelimeler : Anatomy, Endoscopic, Skull Base, Clivus