A 43-year-old male presented with acromegaly after a lack of biochemical remission
from a previous surgery. Key endoscopic endonasal steps including wide bilateral sphenoidotomies,
right middle clinoidectomy to access the clinoidal carotid and the retrogenu compartment,
identification of the top of the paraclival carotid by drilling across the sella floor,
division of the sellar floor dura to increase the intercarotid distance, and transcavernous
mobilization of medial wall.
