Endoscopic neuroanatomy through the sphenoid sinus.

Area of Science:

• Neurosurgery
• Endoscopic Skull Base Surgery
• Anatomy

Background:

• Endoscopic endonasal surgery is increasingly utilized for skull base pathologies.
• A thorough understanding of anatomical relationships is crucial for surgical success.
• The sphenoid sinus provides a unique vantage point for accessing deep skull base structures.

Purpose of the Study:

• To conduct detailed endoscopic anatomical dissections of the skull base through the sphenoid sinus.
• To enhance understanding of endoscopic surgical corridors to skull base lesions.
• To map critical neurovascular and glandular structures accessible via this route.

Main Methods:

• Anatomical dissection of six cadaveric heads using sinus endoscopes.
• Trans-nasal, sublabial approach to enter the sphenoid sinus.
• Progressive bone removal to expose suprasellar, retrosphenoid, and cavernous sinus regions.

Main Results:

• Detailed visualization of the anterior communicating artery complex, optic apparatus, and pituitary gland in the suprasellar area.
• Identification of the basilar artery, mid-brain, pons, and cranial nerves III, V, VI, VII, and VIII in the retrosphenoid space.
• Exposure of the carotid artery and cranial nerves III, IV, V, and VI within the cavernous sinus.

Conclusions:

• The sphenoid sinus serves as a critical endoscopic gateway to the suprasellar, cavernous sinus, and retrosphenoid areas.
• Endoscopic anatomical exploration through the sphenoid sinus confirms broad access to vital skull base structures.
• This anatomical understanding is fundamental for advancing endoscopic skull base surgery techniques.