This document discusses the microanatomy of the sellar and suprasellar regions as well as operative approaches for accessing these areas. It describes the bones, venous connections, arterial relationships and incisura spaces in the regions. Several surgical approaches are mentioned, including sublabial, transseptal, endonasal, and subfrontal transfrontal transsphenoidal approaches. Key anatomical structures like the optic chiasm, carotid protuberance, cavernous sinus and clival indentation are located using an "owl eye" panoramic view of the fetal face mimicking centers.

1. Dr. Shahnawaz Alam
Guided by:-Dr. Vikas Chandra Jha
HOD Neurosurgery
Moderated by:-Dr. Saraj kumar Singh
Asst.Prof. (Dept. of Neurosurgery)
Sellar/Suprasellar Microanatomy
and operative approaches

3. FRONTOETHMOID SUTURE
PPF
Int. maxillary art. & its br.
infratemporal fossa-pterygomaxillary fissure-pterygopalatine fossa
[termnl br of opht A.]

4. Sphenoid Bone and SS

6. Transnasal route to the sphenoid sinus and sella

7. Intercavernous Venous Connections

9. SUPRASELLAR AND THIRD VENTRICULAR REGION

10. Incisura Spaces

11. Arterial Relationships

13. DISCUSSION AND OPERATIVE APPROACHES
Sublabial TS Transseptal TS
endonasal TS

17. OWL EYE APPEARANCE

18. PANORAMIC VIEW MIMICKING FETAL FACE
CENTRE-SELLAR FLOOR
12’O -PS/TS
6’0-CLIVAL INDENTATION
10 & 2’O- OPTIC PROTUBR.
5 & 7’O- CAROTID PROTB.
3 & 9’O- CAVRNS SINUS

20. Subfrontal Exposure of the Suprasellar Region: transfrontal TS
Scalp incision, right frontal bone flap,
dural incision, and placement of self
retaining retractor

21. Subfrontal approach to the
anteroinferior part of the third
ventricle
A. Scalp incision, right frontal bone
flap, dural incision, and placement of
self retaining retractor
B. Subchiasmatic approach
C. Opticocarotid approach
D. Lamina terminalis approach
E. Transfrontal-TS approach.
A prefixed optic chiasm blocks the subchiasmatic
approach to a tumor

23. REFERENCES
1. Rhoton-cranial anatomy and surgical approaches
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