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Related Experiment Videos

Transmaxillary approach to the anterior cavernous sinus: a microanatomic study

W T Couldwell1, I Sabit, M H Weiss

  • 1Department of Surgery, University of North Dakota, Grand Forks, USA.

Neurosurgery
|June 1, 1997
PubMed
Summary

A new transmaxillary approach provides anterior cavernous sinus exposure without craniotomy. This technique offers access to cranial nerves and the internal carotid artery for treating tumors and vascular lesions.

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Area of Science:

  • Neurosurgery
  • Skull Base Surgery
  • Anatomy

Background:

  • Conventional surgical approaches to the anterior cavernous sinus often require craniotomy or extensive facial dissection.
  • Minimally invasive techniques are sought to reduce surgical morbidity and improve access.

Purpose of the Study:

  • To develop and describe a novel transmaxillary approach for accessing the anterior cavernous sinus.
  • To evaluate the feasibility and exposure capabilities of this new surgical corridor.

Main Methods:

  • The transmaxillary approach was developed through 24 cadaveric dissections.
  • Key steps include sublabial incision, maxillotomy, identification of the infraorbital nerve and maxillary nerve, osteotomy of the posterior sinus wall and pterygoid plate, and enlargement of the foramen rotundum.

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Main Results:

  • The technique provides access to all cavernous cranial nerves and the anterior loop of the internal carotid artery up to the ophthalmic artery origin.
  • A mean operative range of 38 mm from the posterior maxilla to the internal carotid artery anterior loop ensures adequate exposure with a short operative distance.

Conclusions:

  • The transmaxillary approach offers a viable, less invasive option for limited exposure of anterior cavernous sinus tumors.
  • This method may also be beneficial for managing certain intracavernous vascular lesions.