Contralateral Transmaxillary Corridor to the Cavernous Sinus: A Useful Adjunct to the Endoscopic Endonasal Approach to the Parasellar Region

Background: Cavernous sinus (CS) invasion influences the extent of resection and is a prognostic factor for recurrence for many sellar/parasellar tumors. The internal carotid artery (ICA) limits access to the parasellar region with a standard endoscopic endonasal approach (EEA), and is at increased risk for injury. The contralateral transmaxillary approach (CTM) has been shown to improve access to the petrous apex deep to the petrous and paraclival ICA. The aim of this study was to investigate the utility of the CTM approach for CS compartments deep to the parasellar ICA.