Endoscopic Endonasal Anatomy around the Sella Turcica in the Era of High-definition Endoscope

Abstract

  The image quality of surgical endoscopes has greatly improved, and there are more opportunities to perform endoscopic endonasal skull base surgery using full high-definition endoscopes or 4K endoscopes. In this article, the anatomy around the sella turcica is presented with cadaver photographs, considering its relationships with intracranial structures, together with the surgical cases. Both the medial optico-carotid and lateral optico-carotid recesses are key structures that promote understanding of endonasal and intracranial anatomy. The vidian canal is also a useful surgical landmark around the internal carotid artery, near the foramen lacerum. Acquiring knowledge of the skull base anatomy both from the cranial and the endonasal side through cadaver training is integral to the pursuit of safer and more effective surgery.