Microsurgical and Endoscopic Anatomy of the Cavernous Sinus

• Main Authors: Gustavo Rassier Isolan, Francisco Luiz Souza Braga, Alvaro Campero, José Alberto Landeiro, Ricardo Marques Lopes de Araújo, Pablo Adjer, Gabriel Reis Sakaya, Nícollas Nunes Rabelo, Josué da Silva Brito, Manoel Jacobsen Teixeira, Eberval Gadelha Figueiredo
• Format: Article
• Language: English
• Published: Thieme Revinter Publicações Ltda. 2020-04-01
• Series: Brazilian Neurosurgery
• Subjects: cavernous sinus; neuroendoscopy; transsphenoidal surgery; parasellar region
• Online Access: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1709740

Objective To describe the endoscopic and microsurgical anatomy of the cavernous sinus (CS) with focus on the surgical landmarks in microsurgical anatomy. Materials and methods Ten formalin-fixed central skull base specimens (20 CSs) with silicone-injected carotid arteries were examined through an extended endoscopic transsphenoidal approach. Fifteen formalin-fixed heads were dissected to simulate the surgical position in CS approaches. Results Endoscopic access enables identification of the anterior and posterior surgical corridors. Structures within the CS and on its lateral wall could be visualized and studied, but none of the triangular areas relevant to the transcranial microsurgical anatomy were fully visible through the endoscopic approach. Conclusion The endoscopic approach to the CS is an important surgical technique for the treatment of pathological conditions that affect this region. Correlating endoscopic findings with the conventional (transcranial) microsurgical anatomy is a useful way of applying the established knowledge into a more recent operative technique. Endoscope can provide access to the CS and to the structures it harbors.