Endoscopic anatomy and approaches of the cavernous sinus: cadaver study

Abuzayed, Bashar; Tanrıöver, Necmettin; Gazioğlu, Nurperi; Özlen, Fatma; Çetin, Gürsel; Akar, Zıya

doi:10.1007/s00276-010-0651-3

Cited by 28 publications

(28 citation statements)

References 28 publications

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“…Endoscopic visualization from "below" has offered the surgeons the possibility to reach the midline anterior skull base without skin incision and brain retraction and with minimal neurovascular manipulation. [9][10][11][12][13][14] As neurosurgeons, we found the posterior-anterior approach to be more suitable in performing ethmoidectomy and exposing the anterior skull base. The reason is that early identification of the sphenoid sinus and the sellar and parasellar regions, which are well known to neurosurgeons, can be achieved using this approach.…”

Section: Discussionmentioning

confidence: 97%

“…In addition, when the lateral septae of the sphenoid sinus exist, these are generally attached to the carotid protuberance and point to the location of the ICA. 10 These important landmarks can help locate the intercavernous ICA and the cavernous sinus before bone resection and opening of the dura, which offers a safer approach. 10 Including the sellar fossa in the bone resection is preferred because wide exposure of the related structures avoids blind manipulation and creates a space for ICA retraction when needed.…”

Section: Discussionmentioning

confidence: 99%

“…Both the anterior and posterior bends of the parasellar portion of the ICA are widely exposed. 8,10 To expose the inferior portion of the cavernous sinus, the superior and middle turbinates and the posterior ethmoidal cells are removed (extended endoscopic endonasal transsphenoidal approach). The anatomic landmarks in the roof of the sphenoid sinus are valuable to determine the anatomic location of the cavernous sinus.…”

Section: Discussionmentioning

confidence: 99%

“…With the introduction of the functional endoscopic sinus surgery, endoscopic techniques and approaches were developed starting from diagnosing techniques 6,7 to endoscopic endonasal transsphenoidal pituitary 8 and extended endoscopic skull base surgeries. [9][10][11][12][13][14] The endoscopic endonasal approach to the midline skull base has become a popular approach for the surgical management of pathologic lesions occupying this region. This popularity was gained because of the advantages offered by this technique, such as minimal invasiveness, less neurovascular retraction and thus lower risk for neurovascular injury, wide view of exposure, no disruption of the facial skeleton, and better postoperative performance of the patients with shorter hospitalization period.…”

mentioning

confidence: 99%

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Neuronavigation-Guided Endoscopic Endonasal Resection of Extensive Skull Base Mucormycosis Complicated With Cerebral Vasospasm

Abuzayed¹,

Al-Abadi²,

Al-Otti³

et al. 2014

Journal of Craniofacial Surgery

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A 24-year-old woman presented with double vision since 6 months. Examination revealed left eye ptosis and bilateral abducens nerve palsy. Brain computed tomographic scan and magnetic resonance imaging revealed a bone-eroding mass lesion located in the middle skull base, occupying the posterior ethmoidal cells, the planum sphenoidale, the sphenoid sinus, the lateral recesses of the sphenois sinus, the pterygoid apexes, and the middle and lower clivus, with compression of the inferior wall of the cavernous sinus and the parasellar and paraclival parts of the internal carotid artery. The patient was operated on with extended endoscopic endonasal approach guided with neuronavigation. Total mass resection was achieved. Histopathologic examination revealed mucormycosis infectious mass. On postoperative day 5, the patient developed right hemiplegia, and brain imaging revealed left internal carotid vasospasm. After treatment, the patient improved and was discharged.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Neuronavigation-Guided Endoscopic Endonasal Resection of Extensive Skull Base Mucormycosis Complicated With Cerebral Vasospasm

Abuzayed¹,

Al-Abadi²,

Al-Otti³

et al. 2014

Journal of Craniofacial Surgery

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“…The usefulness of the endoscope for this region should be stressed. The anterior portion of the cavernous sinus could be exposed by removal the lower part of the middle turbinate and the posterior ethmoidal cells (1,3). The introduction of the endoscope 30 degrees from the contralateral nostril can provide a wide view for the medial wall of the cavernous sinus (1).…”

Section: B a Hayashi Y Et Al: Adenoid Cystic Carcinoma In Cavernous mentioning

confidence: 99%

Adenoid cystic carcinoma in the cavernous sinus diagnosed with endoscopic endonasal approach

Hayashi

Iwato²,

Kita³

et al. 2014

Turkish Neurosurgery

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A 42-year-old woman presented with right oculomotor, abducens, and trigeminal palsy. Neuroimaging revealed a small lesion in the right cavernous sinus mimicking meningioma. Because the symptoms gradually worsened, the patient underwent an endoscopic endonasal transsphenoidal surgery for tumor biopsy. Histological examination of the surgical specimen revealed adenoid cystic carcinoma (ACC). Before and after the operation, no evidence of other primary lesions could be detected. The patient was treated with stereotactic radiosurgery (SRS). ACC in the cavernous sinus can be difficult to diagnosis before histological confirmation, because it is extremely rare as a primary lesion and resembles a cavernous sinus meningioma on neuroimaging studies. Two years after the first SRS, the tumor recurred along the trigeminal nerve and SRS was performed again. Our study illustrates that in case in which a lesion in the cavernous sinus progresses on neurological and neuroimaging studies, a biopsy should be taken to provide most accurate diagnosis and treatment.KEywoRds: Adenoid cystic carcinoma, Cavernous sinus, Endonasal approach, Endoscope, Radiosurgery ÖZ 42 yaşındaki bir kadın sağ okülomotor, abdusens ve trigeminal sinir paralizileri ile başvurdu. Nörogörüntüleme sağ kavernöz sinüste menenjiyomu taklit eden küçük bir lezyon saptadı. Belirtiler yavaş yavaş kötüleştiği için, hastaya tümör biyopsisi için endoskopik endonazal transsfenoidal cerrahi uygulandı. Cerrahi örneğin histolojik incelemesinde adenoid kistik karsinom (ACC) saptandı. Operasyon öncesi ve sonrasında başka bir primer lezyon bulgusu saptanmadı. Hasta stereotaktik radyocerrahi (SRS) ile tedavi edildi. Bir primer lezyon olarak son derece nadir görüldüğü ve beyin görüntüleme çalışmalarında kavernöz sinüs menenjiyomuna benzediği için kavernöz sinüsteki ACC'un tanısını histolojik teyitten önce koymak zor olabilir. İlk SRS'den iki yıl sonra tümör trigeminal sinir boyunca tekrarladı ve yeniden SRS uygulandı. Çalışmamız nörolojik ve beyin görüntüleme çalışmalarında bir lezyonun kavernöz sinüste ilerlediği olgularda en doğru tanı ve tedaviyi sağlamak için biyopsinin alınması gerektiğini göstermektedir.

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Anatomy of the medial wall of the cavernous sinus: A systematic review of the literature

Lefevre,

Dupont,

Liguoro

et al. 2024

Clinical Anatomy

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The existence, composition, and continuity of the medial wall of the cavernous sinus (MWCS) have been extensively studied and debated. However, the precise nature of this membrane remains unknown. Understanding the anatomical characteristics of the MWCS is crucial, notably in relation to pituitary adenomas, which often invade the cavernous sinus. Indeed, surgical treatment of those tumors is frequently incomplete because of such invasion. The anatomical and molecular basis of the peculiar and often lateralized tropism of adenomatous cells to the cavernous sinus is not yet understood and it has been suggested repeatedly that the MWCS is physiologically frail. During the past three decades, there have been several conflicting accounts of the existence, composition, and continuity of this medial wall, but methodological differences and varying definitions could have contributed to the current lack of consensus regarding it. The aim of this systematic review was to summarize previously published data concerning the existence, anatomy, composition, and continuity of the MWCS.

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Endoscopic anatomy and approaches of the cavernous sinus: cadaver study

Cited by 28 publications

References 28 publications

Neuronavigation-Guided Endoscopic Endonasal Resection of Extensive Skull Base Mucormycosis Complicated With Cerebral Vasospasm

Neuronavigation-Guided Endoscopic Endonasal Resection of Extensive Skull Base Mucormycosis Complicated With Cerebral Vasospasm

Adenoid cystic carcinoma in the cavernous sinus diagnosed with endoscopic endonasal approach

Anatomy of the medial wall of the cavernous sinus: A systematic review of the literature

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