Artikel
The blood supply to the intracavernous cranial nerves: comparison of the endoscopic and microsurgical perspectives
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Autoren
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E. d'Avella
- DPT Neurological Sciences, Neurosurgery, “Sapienza” University of Rome, Italy
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M. Tschabitscher
- DPT Neurological Sciences, Neurosurgery, “Sapienza” University of Rome, Italy
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A. Pichierri
- DPT Neurological Sciences, Neurosurgery, “Sapienza” University of Rome, Italy
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A. Santoro
- DPT Neurological Sciences, Neurosurgery, “Sapienza” University of Rome, Italy
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R. Delfini
- DPT Neurological Sciences, Neurosurgery, “Sapienza” University of Rome, Italy
| Veröffentlicht: | 30. Mai 2008 |
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Gliederung
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Objective: To provide a comparative description of the endoscopic and microsurgical anatomic features of the blood supply to the cranial nerves in the lateral wall of the cavernous sinus.
Methods: 24 cavernous sinuses were dissected in 12 adult cadaveric heads. Endoscopic observations were made with 0° and 45° 4mm rod-lens endoscope and the lateral wall of the cavernous sinus was exposed through an endonasal transsphenoidal approach. The microsurgical observations were performed with a surgical microscope with possible magnification from X4 to X40 through a lateral transcranial approach. Neurovascular relationships in the lateral wall of the cavernous sinus were noted and the endoscopic and microsurgical perspectives compared.
Results: The neurovascular relationships in the lateral wall of the cavernous sinus that are visible during the endonasal transsphenoidal approach but not visible during the transcranial microsurgical one are as follows: between the oculomotor nerve and the tentorial artery; between the distal segment of the trochlear nerve and the tentorial artery; between the ophthalmic nerve and the inferolateral trunk and between the abducens nerve and the inferolateral trunk. The neurovascular relationships visible during the transcranial microsurgical approach but not visible during the transsphenoidal endoscopic approach are: between the oculomotor nerve and the supero-proximal artery when present; between the proximal segment of the trochlear nerve and the supero-proximal artery.
Conclusions: Incorporating the endoscopic and microsurgical perspectives ensures a better understanding of the neurovascular relationships in the cavernous sinus lateral wall. This information could be relevant for preservation of the blood supply to the nerves during surgery in or around the cavernous sinus.
