Transclival

Transclival refers to a surgical approach used to access lesions located at the skull base, specifically in the region of the clivus. The clivus is a bony structure at the base of the skull, posterior to the sphenoid sinus and anterior to the foramen magnum. Lesions in this area, such as meningiomas, chordomas, or metastases, can be difficult to reach due to their deep location and proximity to vital neurovascular structures.

The transclival approach involves a surgical pathway that traverses the clivus. Historically, this has been achieved through various routes, including transnasal, transoral, and infratemporal approaches. More recently, endoscopic techniques have gained prominence, allowing for minimally invasive access to the clival region through the nasal cavity. This endoscopic transnasal approach offers advantages such as reduced morbidity and faster recovery compared to traditional open surgeries.

The goal of a transclival approach is to achieve safe and complete resection of the target lesion while preserving surrounding neurological function. Surgeons must carefully navigate through complex anatomical structures, including cranial nerves, the brainstem, and major blood vessels. The specific technique employed depends on the size, location, and nature of the lesion, as well as the surgeon's expertise. Postoperative care typically involves monitoring for neurological deficits and managing potential complications.