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Three-dimensional illustration (sagittal cut, oblique view) of Liliequist’s membrane composed of two separate diencephalic (aqua) and mesencephalic (pink) leaves that originate at the dorsum sellae (Type A). Note the posterior communicating artery coursing above the mesencephalic leaf. Inset, with removal of the diencephalic leaf, the mesencephalic leaf can be seen surrounding the oculomotor nerve and reflecting onto the tentorial edge (Courtesy of Mayfield Clinic).
Drawing showing skin incision (inset) along the sternocleidomastoid muscle (SCM) and extended superiorly in the preauricular and postauricular regions. Neck dissection is performed below and above the posterior belly of the digastric muscle (DM). Colored areas depict steps ofdissection: Step 1 (green), anterior SCM approach; Step 2 (yellow), retroparotid dissection and section of the DM; Step 3 (violet), section of the styloid apparatus; Step 4 (red), mandibulotomy. MP, mastoid process; PG, parotid gland; SP, styloid process; TMF tympanomastoid fissure; V2, CN VII (courtesy of the Mayfield Clinic).
Illustration of the coronal section showing the sellar and parasellar regions. Note the dural reflection of the diaphragma sella and its continuation laterally and inferiorly as the medial wall of the cavernous sinus. Cranial nerves III, IV, V1, and V2 of the lateral wall are seen within the inner membranous layer, whereas the internal carotid artery (ICA) and cranial nerve VI are intracavernous (ACA 5 anterior cerebral artery; MCA 5 middle cerebral artery). (Reprintedn with permission from the Mayfield Clinic.)
Illustration of the anatomy of a cavernous sinus fistula.
Artist’s drawing (inferior view from within rib cage of thoracic apex) depicting nerve roots that form brachial plexus. T1 nerve root crosses over first rib and joins C8 nerve root to form lower trunk (LT) of brachial plexus. (With permission from the Mayfield Clinic.)
Endonasal endoscopic approach to the pterygopalatine fossa. (A) Maxillary antrostomy made in the medial wall of the maxillary sinus. A mucoperiosteal flap is reflected posteriorly to the crista ethmoidalis (CE) to expose the sphenopalatine artery (SPA) and posterior nasal artery (PNA) emerging from the sphenopalatine foramen. (B) Crista ethmoidalis and sphenopalatine foramen are enlarged with a drill. The posterior wall of the maxillary sinus is removed in a medial-to-lateral manner to the edge of the infraorbital nerve (IN). Elevation of the large fat pad, occupying the pterygopalatine fossa, exposes the internal maxillary artery (IMA) and its branches, the sphenopalatine and posterior nasal arteries, which are clipped and ligated. (C) With the use of a drill or Kerrison rongeur, the greater palatine nerve (GPN) is safely mobilized from its bony canal inferiorly. Gentle lateral retraction of the ganglion and GPN reveals the vidian nerve (VN) emerging from the vidian canal (VC) and exposes the pterygoid plate. (Reprinted with permission the Mayfield Clinic.)