The sphenoid is the central skull base bone articulating with every other cranial bone, making it the architectural keystone of the skull base. Its body contains the sphenoidal sinuses (largest paranasal sinuses with the sella turcica — the pituitary fossa — on its superior surface). The greater and lesser wings form parts of the middle cranial fossa and orbit. Six foramina transmit the cranial nerves: superior orbital fissure (CN III, IV, V1, VI), foramen rotundum (V2), foramen ovale (V3), foramen spinosum (middle meningeal artery), foramen lacerum, and optic canal (CN II and ophthalmic artery).
Transsphenoidal hypophysectomy for pituitary tumours approaches the sella through the sphenoidal sinuses — the surgical corridor passes through the nose, sphenoidal sinus, and sella floor. Sphenoid sinus mucoceles and invasive pituitary adenomas can erode the sella floor. The sphenoid bone's central position means skull base tumours frequently involve it.
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