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Fig 1.

Measurement of the clivus in the sagittal plane of the CT image.

1A: Measurement of the length and angle clivus in sagittal plane in CT image (bone window); Rc: The angle between the clivus and the horizontal plane; Lc: the length of the clivus; Line H: The horizontal line. 1B: Distance from the lowest point of the sellar floor (SF) to the clivus and vertebral artery in CT image (soft-tissue window): DA: The horizontal distance from the lowest point of SF to the posterior boundary of the clivus; Point B: The middle lowest point of the SF.

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Fig 2.

Measurement of the angle of clivus in sagittal plane in skull specimen.

Rc: The angle between the clivus and the horizontal plane; Line H: The horizontal line.

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Fig 3.

Thickness of clivus.

3A: Measurement of the thickness of the clivus in the mid-sagittal plane: T1M: the thickness of the middle portion of the clivus in the middle; T2M: the thickness of the inferior portion of the clivus in the middle; 3B: Measurement of the thickness of the clivus in sagittal plane through the posterior nares: T1R (L): the thickness of middle portion of the clivus in the right (left); T2R (L): the thickness of the inferior portion of the clivus in the right (left).

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Fig 4.

The distance between the middle turbinate (MT) and anterior margin of foramen magnum.

DN: The distance between the posterior point of MT and anterior margin of foramen magnum; RN: The angle between the line from the posterior point of MT to anterior margin of foramen magnum and the horizontal plane; Line H: the horizontal line; MT: middle turbinate; FM: foramen magnum.

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Fig 5.

Location of petrous apex (PA) by the posterior point of inferior turbinate (IT) in the sagittal plane.

DPA: Distance between the posterior point of IT and PA; RA: Angle between the line from the posterior point of IT to PA and the horizontal plane; Line H: the horizontal line; IT: inferior turbinate; ICA: internal carotid artery; PA: petrous apex.

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Fig 6.

Distance between ICA and the mid-sagittal line in the position superior and inferior of the petrous apex (PA).

6A: Position of the axial plane selected for the measurement: Line P: Position of the axial plane through PA; Line P1: Position of the axial plane 10 mm superior to Line P; Line P2: Position of the axial plane 10 mm inferior to Line P. 6B: Axial plane 10 mm superior to PA. Line M: mid-sagittal line; DP1: distance between ICA and the sagittal middle line; ICA: internal carotid artery; 6C: Axial plane through PA. Line M: mid-sagittal line; DP: distance between ICA and the sagittal middle line; ICA: internal carotid artery; 6D: Axial plane 10 mm inferior to the petrous apex. Line M: mid-sagittal line; DP2: distance between ICA and the mid-sagittal line; ICA: internal carotid artery.

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Fig 7.

Measurement of safe region for penetration of the clivus.

7A: Position of the axial plane selected for the measurement: Line B: Position of axial plane through middle lowest point of SF in Fig 7B; Line C: Position of the axial plane through apertura sinus sphenoidalis in Fig 6C; Line D: Position of the axial plane through the upper aspect of foramen lacerum in Fig 6D; Line E: Position of the axial plane passing through the superior margin of the nostril in Fig 6E. 7B: Axial plane through the lowest central point of the SF: Line M: mid-sagittal line; Point B: lowest, central point of the SF; ICA: internal carotid artery; D1: distance between the medial wall of the internal carotid artery and mid-sagittal line. 7C: axial plane through apertura sinus sphenoidalis: Line M: mid-sagittal line; ASS: apertura sinus sphenoidalis; ICA: internal carotid artery; SPS: sulcus of the inferior petrosal sinus; D2: Distance between the medial wall of the ICA and mid-sagittal line. D5: Distance between sulcus of the inferior petrosal sinus and the mid-sagittal line. 7D: axial plane through upper of the foramen lacerum: Line M: the mid-sagittal line; SPS: sulcus of the inferior petrosal sinus; FL: foramen lacerum; D3: Distance between the medial margin of the foramen lacerum and mid-sagittal line; D6: Distance between the sulcus of the inferior petrosal sinus and the mid-sagittal line. 7E: axial plane through the superior margin of the nostril: Line M: mid-sagittal line; SPS: sulcus of the inferior petrosal sinus; D4: Distance between the medial wall of the ICA and mid-sagittal line; D7: Distance between the sulcus of inferior petrosal sinus and the mid-sagittal line. 7F: Distance between foramen jugulare to mid-sagittal line at SF. DF: Distance between the foramen jugulare to the mid-sagittal line at SF; Line M: the sagittal midline; FJ: foramen jugulare.

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Fig 8.

Sulcus of the inferior petrosal sinus measured in the specimen.

Line M: Mid-sagittal line; Curve S: the medial boundary of the sulcus of the inferior petrosal sinus (safe corridor for fenestration of the posterior aspect of the clivus); SPS: sulcus of the inferior petrosal sinus; D5: Distance between the sulcus of the inferior petrosal sinus and the mid-sagittal line; D6: Distance between the sulcus of the inferior petrosal sinus and mid-sagittal line; D7: Distance between the sulcus of the inferior petrosal sinus and mid-sagittal line.

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Fig 9.

Location of trigeminal nerve in the MR image.

9A: Distance from the initial part of the trigeminal nerve to the mid-sagittal line; Line M: mid-sagittal line; TN: trigeminal nerve; D8: distance between the root of the trigeminal nerve and the mid-sagittal line. 9B: Line S: Position of the axial plane in plane 8A; PG: the pituitary gland; D9: the distance between the axial plane through the root of trigeminal nerve and lowest, central point of the SF.

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Fig 10.

Location and measurement of soft palate in the view of endoscopic trans-nasal surgery.

10A: Sagittal middle plane: DH: Distance between the nostril and the anterior part of the soft palate. RH: The angle between horizontal direction of soft palate and the direction of the soft palate. Line HP: The line in accordance with the horizontal direction of the hard palate. 10B: Sagittal plane 10 mm right of mid-sagittal plane. DH1: Distance between the nostril and the anterior part of the soft palate. RH1: The angle between horizontal direction of soft palate and the direction of the soft palate. Line HP: 10C: Coronal plane through the anterior point of soft palate. DT: Vertical distance between the inferior turbinate and soft palate in the coronal plane through the anterior part of the soft palate; DT1: Vertical distance between the inferior turbinate and soft palate; IT: inferior turbinate; SP: soft palate. 10D: Coronal plane through the posterior point of inferior turbinate. DT1: Vertical distance between the inferior turbinate and soft palate.

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Table 1.

Thickness of clivus (mm).

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Table 2.

Distance between the medial wall of the ICA and mid-sagittal line (mm).

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Table 3.

Distance between sulcus of the inferior petrosal sinus and the mid-sagittal line (mm).

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Table 4.

Distance between sulcus for inferior petrosal sinus and the sagittal midline in specimen (mm).

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Table 5.

The location of the soft palate in the view of endoscopic trans-nasal surgery to clivus region.

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