Surgical anatomy of the dural walls of the cavernous sinus

Campero, Álvaro; Martins, Carolina; Yasuda, Alexandre; Rhoton, Albert L.

doi:10.1016/j.jocn.2009.10.015

Cited by 81 publications

(80 citation statements)

References 24 publications

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“…Accordingly, the investigations of Yilmazlar et al [27] showed that the medial wall of the CS is a distinct dural layer that forms a barrier between the medial venous space of the cavernous sinus and the pituitary gland. As stated by Campero et al [2], the medial wall of the CS has two areas-sellar and sphenoidal, both made up of one dural layer.…”

Section: Discussionmentioning

confidence: 87%

“…2 An image of the pituitary gland which is taught to be contained within a dural layer that limits the CS medially Fig. 1 The cavernous sinus is located on either side of the sphenoid sinus, sella, and pituitary gland extending from the superior orbital fissure to the petrous ridge of the temporal bone identified a dural layer [12] forming the medial wall of the CS and separating the CS from the sella and pituitary capsule [14,25,26], or separating the CS directly from the pituitary gland [2,3,6,8,23,27] (Fig. 3).…”

Section: Resultsmentioning

confidence: 99%

“…The second group, which identified the medial wall of the CS as comprised of a dural layer, did not utilize MRI in their methodology. However, 61.5% prosecuted microscopic dissection [2,3,8,12,14,[25][26][27], and 38.5% used histological section with Masson's trichrome, hematoxylin and eosin, or hemalaun, eosin, and saffron [6,8,14,23,27]. In one study, the thickness of the pituitary capsule and the inferior and lateral pituitary fossae was measured, and the collagen structure from these layers was analyzed [14], while in another study, computer measurements of medial wall of the CS thickness were compared in the three different regions (posterior, middle, and anterior) and also on the left vs. the right sides [27].…”

Section: Resultsmentioning

confidence: 99%

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Cavernous sinus medial wall: dural or fibrous layer? Systematic review of the literature

et al. 2011

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The cavernous sinus (CS) has one of the most complex anatomical networks of the skull base and because of the diversity of its contents is involved in many pathological processes. Nevertheless, anatomical literature concerning the CS is still controversial, so a systematic literature review was performed to find out the microanatomy of the medial wall of the CS and its clinical importance on sellar pathologies. Experimental studies from English-language literature between 1996 and 2010 were identified in MEDLINE, LILACS, and Cochrane databases. After analysis, two tables were prepared exhibiting the major points of each article. Fourteen experimental studies were included in the tables. Four studies concluded that the medial wall of the CS is composed of a loose, fibrous structure, and the remaining ten presumed that the medial wall is formed by a dural layer that constitutes the lateral wall of the sella. The lack of definition standards and of methodological criteria led to variation in the results among different studies. Thus, this hindered results comparison, possibly explaining the different observations.

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Section: Discussionmentioning

confidence: 87%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Cavernous sinus medial wall: dural or fibrous layer? Systematic review of the literature

et al. 2011

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“…Furthermore, because the MWCS is the only dural barrier between the tumor and CS compartments, defects in the MWCS are a direct sign of CSI [15]. However, visualization of the MWCS on MRI is difficult, and neurosurgeons have traditionally relied on indirect predictors that do not provide detailed information on the location of MWCS defects and invasion of tumor into CS compartments [16].…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging appearance of the medial wall of the cavernous sinus for the assessment of cavernous sinus invasion by pituitary adenomas

Cao

Chen

Jiang

et al. 2013

Journal of Neuroradiology

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“…The ICA and CN VI pass through the CS sinusoids. [2] Cranial nerves III, IV, and V1 exit the cranium through the superior orbital fissure, the V2 exits the cranium through the foramen rotundum.…”

Section: Introductionmentioning

confidence: 99%

Coffee cup model of the cavernous sinus

Kranzler¹

2015

Anatomy

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The cavernous sinus (CS) is a complex venous space that lies on the lateral sides of the sella turcica surrounded by the meningeal and periosteal dural folds. The sinus extends from the superior orbital fissure to the apex of the petrous temporal bone, with an average length of 2 cm and a width of 1 cm. The internal carotid artery (ICA), with the sympathetic plexus around it, passes forward through the sinus together with the abducens nerve (VI) which lies lateral to the artery. The oculomotor (III) and trochlear nerves (IV) and the ophthalmic (V1) and maxillary divisions (V2) of the trigeminal nerve all lie in the lateral wall of the sinus. [1] The lateral wall of the CS has two layers; the external layer is thick and pearly grey, and the internal is semitransparent and contains the cranial nerves. These layers can be surgically separated to expose the III, IV and V1. The medial wall of the CS has two areas, sellar and sphenoidal, both of which are made up of one dural layer only. The superior wall, also called the CS roof, is formed by three triangles: oculomotor, clinoid and carotid triangles. CN III is located in a cisternal space in the oculomotor triangle. The posterior wall is part of the dura that covers the clivus, made up of the meningeal and periosteal dural layers. This wall is close to the vertical segment of the abducens nerve (VI), from the point of its dural perforation to where it changes direction at the level of Dorello's canal. The cavernous segment of the ICA with its accompanying sympathetic neural plexus continues just medial to the CN VI. The ICA and CN VI pass through the CS sinusoids.[2] Cranial nerves III, IV, and V1 exit the cranium through the superior orbital fissure, the V2 exits the cranium through the foramen rotundum.The anatomical structures of the CS can be invaded by neoplastic, infectious, inflammatory, and vascular lesions. There are two ways of approaching the CS, intradural, with access to the CS via its dural roof through the anteromedial or medial triangle; and extradural, with access to the CS through its lateral wall, through the paramedial, Parkinson's, anterolateral or lateral triangles after surgically separating the two dural layers and identifying CN III, IV, and V. A posterior approach is also possible, though very difficult. [3,4] The choice of surgical approach depends mainly on the location of the lesion and its nature.A precise knowledge of the complex anatomy of the CS, together with pathological processes and their imaging characteristics will enable accurate evaluations of the conditions that affect the CS. This article presents a model (coffee cup model) of the CS that enables us to learn morphological features of the CS. Coffee cup model of the cavernous sinus Leonard KranzlerDepartment of Neurological Surgery, University of Chicago, Chicago, IL, USA AbstractThe cavernous sinuses are complicated venous structures comprising important neurovascular structures, the internal carotid artery and the oculomotor, trochlear, ophthalmic, maxillary and abducens n...

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Surgical anatomy of the dural walls of the cavernous sinus

Cited by 81 publications

References 24 publications

Cavernous sinus medial wall: dural or fibrous layer? Systematic review of the literature

Cavernous sinus medial wall: dural or fibrous layer? Systematic review of the literature

Magnetic resonance imaging appearance of the medial wall of the cavernous sinus for the assessment of cavernous sinus invasion by pituitary adenomas

Coffee cup model of the cavernous sinus

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