Transnasal endoscopic surgical approaches to the clivus

Transnasal endoscopic-assisted techniques to the clivus region can be safe and effective. Endoscopic-assisted approaches provide improved visualization and are a superior alternative to open surgical approaches in most cases. Nevertheless, problems such as infection, CSF leakage, and difficulty controlling intradural bleeding still remain. Surgeons must always remember that, although high technology such as endoscopes, image-guided surgery systems, imaging studies, and advanced anesthetic drugs were essential for the development and improvement of the skull base surgery, the success of this type of surgery depends on perfect knowledge of the anatomy, intense endoscopic surgery training, and a multidisciplinary partnership.