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Three-Dimensional Preoperative Virtual Planning in Derotational Proximal Femoral Osteotomy

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Middle fossa triangles - A step-by-step dissection.

Magno Rocha Freitas Rosa¹, Flavio Nigri¹, Vanessa Milanese Holanda Zimpel²

¹Department of Surgical Specialties and Neurosurgery, Pedro Ernesto University Hospital, Rio de Janeiro.

Surgical Neurology International

|May 8, 2023

Summary

This summary is machine-generated.

This study systematically reviews cavernous sinus anatomy and surgical corridors using middle fossa triangles. A step-by-step dissection provides a roadmap to improve neurosurgeon comfort and patient outcomes.

Keywords:

Cavernous sinus Microneuroanatomy Middle fossa Skull base Triangles

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Area of Science:

Neurosurgery
Surgical Anatomy

Background:

Cavernous sinus and middle fossa surgical approaches present challenges, particularly for less experienced neurosurgeons.
These complex anatomical regions remain difficult subjects for many practitioners.

Purpose of the Study:

To systematically review the anatomy of the cavernous sinus and middle fossa.
To provide a step-by-step dissection guide of the middle fossa triangles as a surgical roadmap.

Main Methods:

Performed step-by-step dissections of the cavernous sinus in two fresh-frozen cadavers.
Described the anatomy of ten distinct middle fossa triangles to demonstrate surgical access feasibility.

Main Results:

Dissected triangles (clinoidal, carotid-oculomotor, supratrochlear, optic-carotideal, oculomotor) enabled intradural cavernous sinus roof opening for superior views.
Extradural exploration via middle fossa floor peeling revealed infratrochlear, anteromedial, and anterolateral triangles.
Middle fossa floor dissection facilitated posterior fossa access through anterior petrosectomy; adjacent triangle exploration broadened surgical corridors.

Conclusions:

Systematic anatomical study and direct approaches can demystify cavernous sinus surgery.
Enhanced understanding and comfort in navigating these complex spaces can ultimately benefit patient treatment.