Fig. 5.

Preoperative (a, c) and postoperative (b, d) axial and coronal CT scans in the bone window demonstrating the right contralateral mononostril endonasal approach to the left cavernous sinus (CS). (a, c) The median sphenoid sinus (SS) septation lies in the midline, while a left SS septation inserts onto the left cavernous internal carotid artery (ICA) prominence. These septations represent important intrasphenoidal landmarks. (b, d) Through a left transrostral corridor, only a left hemi-sphenoidotomy is performed. The parasellar mini-craniotomy is reconstructed, the left hemisinus is filled with abdominal fat, and the rostral mucosa is sutured. Nasal anatomy is preserved as much as possible. Abbreviations: Med. SSs., median sphenoid sinus septation; SSs., sphenoid sinus septation.