Anatomical study of the lateral wall of the cavernous sinus, emphasizing dural construction and neural relations
University of Ankara, Faculty of Medicine, Department of Anatomy, Sihhiye, Turkey. Neurosurgical Review
(Impact Factor: 2.18).
04/2000; 23(1):45-8. DOI: 10.1007/s101430050031
This study aims to determine the microscopic anatomy of the layers of the lateral wall of the cavernous sinus (CS) and, in particular, intends to examine the location and relations of the dural openings on the deep layer. Forty sides of 20 formalin-fixed and fresh cadavers were dissected and their CS examined. In 12 cases we found an opening on the deep dural layer; however, in four of them the inferolateral trunk of the internal carotid artery (ICA) was identified through these dural openings. We noticed the trochlear nerve making a curve (5% of cases) or lying close to the ophthalmic nerve (12.5%) on the lateral wall. In one case, the triangular area described by Parkinson could not be exposed surgically. Our findings indicate the importance of the heterogeneous courses of the cranial nerves lying on the lateral wall and point to the significance of the dural openings, which can influence the etiology of neoplastic invasions originating from the CS.
Available from: Ming Zhang
- "Three weak points of the sinus wall were identified for tumor invasion . Although anatomy of the boundaries and neurovascular structures in the cavernous sinus has been extensively studied , , , , , , , , , , few studies have focused on the fibrous supporting matrix within the sinus , , , . Understanding of configuration and localization of fibrous trabeculae and adipose tissue in the cavernous sinus may be valuable for better understanding of tissue patterning in the cranial base and better evaluation of intracavernous disorders, e.g. the growth direction and extent of intracavernous tumors , . "
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ABSTRACT: Three-dimensional anatomical appreciation of the matrix of the cavernous sinus is one of the crucial necessities for a better understanding of tissue patterning and various disorders in the sinus. The purpose of this study was to reveal configuration of fibrous and adipose components in the cavernous sinus and their relationship with the cranial nerves and vessels in the sinus and meningeal sinus wall.
Nineteen cadavers (8 females and 11 males; age range, 54-89 years; mean age, 75 years) were prepared as transverse (6 sets), coronal (3 sets) and sagittal (10 sets) plastinated sections that were examined at both macroscopic and microscopic levels.
Two types of the web-like fibrous networks were identified and localized in the cavernous sinus. A dural trabecular network constituted a skeleton-frame in the sinus and contributed to the sleeves of intracavernous cranial nerves III, IV, V1, V2 and VI. A fine trabecular network, or adipose tissue, was the matrix of the sinus and was mainly distributed along the medial side of the intracavernous cranial nerves, forming a dumbbell-shaped adipose zone in the sinus.
This study revealed the nature, fine architecture and localization of the fine and dural trabecular networks in the cavernous sinus and their relationship with intracavernous cranial nerves and vessels. The results may be valuable for better understanding of tissue patterning in the cranial base and better evaluation of intracavernous disorders, e.g. the growth direction and extent of intracavernous tumors.
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ABSTRACT: Carotid cavernous fistulae are an uncommon disorder, actually consisting of 2 disease processes. One category is a direct internal carotid artery to cavernous sinus fistula. A second category is the indirect or dural type carotid cavernous fistula. It is the purpose of this article to provide an overview of the anatomy of the cavernous sinus and to discuss the classification, clinical findings, diagnostic imaging evaluation, reasons for misdiagnosis, and treatment options.
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