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Microsurgical anatomy of the cavernous sinus and limitations of surgical approaches: a cadaveric study
, 2, 2
Affiliations- Department of Neurosurgery, Istinye University Medical Park Gaziosmanpasa Hospital, Gaziosmanpaşa, Istanbul, Turkey
- Department of Anatomy, School of Medicine, Istinye University, Zeytinburnu, Istanbul, Turkey
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Abstract
Background: The endoscopic endonasal approach is common in the treatment
of pathologies in and around the cavernous sinus. This cadaveric study aims to
examine the anatomy of the cavernous sinus to guide endoscopic studies and
determine points to consider during surgical approaches.
Materials and methods: For this study, a total of 7 cadavers, 4 male and 3 female,
were injected with coloured silicone and dissections were performed under the
microscope. The characteristics of the surgical corridors encountered during the
transsphenoidal, transsellar and transcavernous approaches were examined and
their images were recorded.
Results: The stages and limitations of surgical approaches to the cavernous sinus
in cadavers are presented. The anatomical features of the triangles defined in the
cavernous sinus and the structures they contain are explained. It was determined
that the surgical field formed by clinoidal and anteromedial triangles could be
used effectively to reach cavernous sinus pathologies during endoscopic endonasal
interventions. It was also observed that supratrochlear and infratrochlear triangles
are dangerous for such surgical interventions.
Conclusions: The detailed anatomical features related to the cavernous sinus,
revealed in our cadaveric study, are valuable in terms of preventing complications
that may occur during surgical interventions.
Abstract
Background: The endoscopic endonasal approach is common in the treatment
of pathologies in and around the cavernous sinus. This cadaveric study aims to
examine the anatomy of the cavernous sinus to guide endoscopic studies and
determine points to consider during surgical approaches.
Materials and methods: For this study, a total of 7 cadavers, 4 male and 3 female,
were injected with coloured silicone and dissections were performed under the
microscope. The characteristics of the surgical corridors encountered during the
transsphenoidal, transsellar and transcavernous approaches were examined and
their images were recorded.
Results: The stages and limitations of surgical approaches to the cavernous sinus
in cadavers are presented. The anatomical features of the triangles defined in the
cavernous sinus and the structures they contain are explained. It was determined
that the surgical field formed by clinoidal and anteromedial triangles could be
used effectively to reach cavernous sinus pathologies during endoscopic endonasal
interventions. It was also observed that supratrochlear and infratrochlear triangles
are dangerous for such surgical interventions.
Conclusions: The detailed anatomical features related to the cavernous sinus,
revealed in our cadaveric study, are valuable in terms of preventing complications
that may occur during surgical interventions.
Keywords
cadaver, endoscopic endonasal, transcavernous approach, transsphenoidal surgery, cranial nerves, internal carotid artery
About this articleTitle
Microsurgical anatomy of the cavernous sinus and limitations of surgical approaches: a cadaveric study
Journal
Issue
Article type
Original article
Pages
805-813
Published online
2022-12-22
Page views
850
Article views/downloads
805
DOI
Pubmed
Bibliographic record
Folia Morphol 2023;82(4):805-813.
Keywords
cadaver
endoscopic endonasal
transcavernous approach
transsphenoidal surgery
cranial nerves
internal carotid artery
Authors
H. Kına
A. Ayran
İ. Demirtaş
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