• Alexey N Shkarubo, Konstantin V Koval, Mikhail A Shkarubo, Ilia V Chernov, Dmitry N Andreev, and Andrey A Panteleyev.
• Department of Neurooncology, Federal State Autonomous Institution, N. N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russia.
• World Neurosurg. 2018 Nov 1; 119: e825-e841.

ObjectiveTo present the basic topographic and anatomic features of the clivus and adjacent structures with an objective of possible improvements and optimization of the extended endoscopic endonasal posterior (transclival) approach when removing tumors of the clivus and anterior regions of the posterior cranial fossa.Materials And MethodsA craniometric study was conducted on 125 human skulls. A topographic anatomic study was conducted on 25 cadaver head specimens with arterial and venous beds stained with colored silicone, according to the method developed by us, to visualize its features and individual variability.ResultsThe most important anatomic features of the external and internal regions of the clivus and the adjacent neural and vascular structures were analyzed. An accessible zone for the most effective transclival approach to the posterior cranial fossa is also specified.ConclusionThe endoscopic endonasal transclival approach can be used to obtain access to centrally located tumors of the posterior cranial fossa. It is an alternative to transcranial approaches in the surgical treatment of tumors of the clivus.Copyright © 2018 Elsevier Inc. All rights reserved.

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