[Transnasal endoscopic anatomy and approaches to the cavernous sinus]

Area of Science:

• Neurosurgery
• Anatomy
• Endoscopic Surgery

Context:

• The cavernous sinus is a critical neurovascular structure at the skull base.
• Surgical access to the cavernous sinus presents significant challenges due to its complex anatomy.

Purpose:

• To delineate the transnasal endoscopic anatomy of the cavernous sinus.
• To describe surgical approaches for accessing the cavernous sinus and its related structures.

Summary:

• Dissection of silicon-injected cadaveric heads via endoscopic endonasal approach revealed detailed cavernous sinus anatomy, including its four walls, five venous compartments, and arterial branches.
• Key cranial nerves (III, IV, V1, VI) and their relationship to the internal carotid artery within the cavernous sinus were identified.
• Two primary surgical approaches, trans-sphenoid-sellar-medial and trans-ethmoid-pterygoid-sphenoid-lateral, were detailed, highlighting their respective exposure capabilities.

Impact:

• Provides crucial anatomical knowledge for neurosurgeons operating in the cavernous sinus region.
• Enhances understanding of surgical corridors for treating pathologies involving the cavernous sinus.
• Facilitates improved surgical planning and outcomes for complex skull base procedures.