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Surgical Anatomy of the Cavernous Sinus

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Brain Anatomy and Neurosurgical Approaches

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Abstract

The cavernous sinus—classically considered a surgical “no-man’s-land”—can be approached if its surgical anatomy is well known. The cavernous sinus is not a sinus but an interperiosteodural space between the sellar lodge medially and the dura of the temporal fossa laterally. This parasellar lodge is in continuity with the orbit content through the superior orbital fissure. Further, it is not a cavernous structure but is made of venous plexus interconnecting affluents and drainages. It is crossed (together with the abducens nerve) by the internal carotid artery that may be controlled proximally at the foramen lacerum using a subtemporal-extradural petrous apex approach, and distally at the paraclinoid space after an anterior clinoidectomy. The oculomotor, trochlear, and ophthalmic nerves can be dissected free on their traveling within the two layers of the lateral dural wall until the orbit. Noteworthy, the Meckel’s cave, with the trigeminal system inside, is an independent anatomical entity.

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Abbreviations

ACP:

Anterior clinoid process

APCF:

Anterior petroclinoid fold

CN:

Cranial nerves

CS:

Cavernous sinus

FL:

Falciform ligament

ICA:

Internal carotid artery

ICL:

Interclinoidal ligament

LS:

Limbus sphenoidale

LWSph:

Lesser wing of the sphenoid bone

MCF:

Middle cranial fossa

PCP:

Posterior clinoid process

PG:

Pituitary gland

PPCF:

Posterior petroclinoid fold

PPL:

Petrolingual ligament

SOF:

Superior orbital fissure

SSPL:

Superior sphenopetrosal ligament

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Author information

Authors and Affiliations

  1. University of Lyon 1, Lyon, France

    Marc Sindou & Timothée Jacquesson

  2. Department of Anatomy, Lyon, France

    Timothée Jacquesson

  3. Skull Base Unit, Department of Neurosurgery B, Neurological Hospital Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France

    Timothée Jacquesson

Authors
  1. Marc Sindou
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  2. Timothée Jacquesson
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Corresponding author

Correspondence to Timothée Jacquesson .

Editor information

Editors and Affiliations

  1. Division of Neurological Surgery, University of Sao Paulo, São Paulo, São Paulo, Brazil

    Eberval Gadelha Figueiredo

  2. Neurosurgery Department, University of Sao Paulo, São Paulo, Brazil

    Nícollas Nunes Rabelo

  3. Department of Neurosurgery, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil

    Leonardo Christiaan Welling

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Sindou, M., Jacquesson, T. (2023). Surgical Anatomy of the Cavernous Sinus . In: Figueiredo, E.G., Rabelo, N.N., Welling, L.C. (eds) Brain Anatomy and Neurosurgical Approaches . Springer, Cham. https://doi.org/10.1007/978-3-031-14820-0_26

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  • DOI: https://doi.org/10.1007/978-3-031-14820-0_26

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