Microanatomical Study Of The Cavernous Sinus Region

Objective To investigate the microvasculature of the cavernous sinus(CS) and to provide anatomical basis for the operation of the CS region. Methods @II~The corrosion cast specimens of the CS in fetus were observed by scanning electron microscopy; ~ Histological slices of the CS in fetus stained with HE were observed under microscopy; 甇sseous structures of anterior clinoid process(ACP) and superior orbital fissure (SOF) were observed and measured in 60 sides of dry adult cadaveric heads under microscopy; ~The walls of the CS and the triangles related to them, the intracavernous carotid artery, the intracavernous cranial nerves , the horizontal portion of the petrous segment of the internal carotid artery(ICA), the clinoid space, the region of the SOF and Dorello抯 canal were observed and measured in 30 sides of adult cadaveric heads under microscopy. Results OThe microvasculature of the CS in fetus was mainly composed of many cavemousoid structures and the connective tissue; ?Parkinson抯 triangle wasl3.28 ?3.77mm X 15.19 ?3.84mm X 5.52 ?1.06mm , while Mullan抯 triangle wasl5.09?.l2mm X 10.91 ?.O3mmX 8.81 ?.38mm; In 60% of the specimens, the deep dural layer of the lateral wall of the CS was incomplete, which was located in the posterior part of Parkinson抯 triangle and the anterior part of Mullan抯 triangle; ㎝ost intracavernous cranial nerves received branches from the inferior artery of CS; ~1~The distances from ICA to the anterior part ,the medial part and the posterior part of the lateral wall of the CS werel.32?1.12mm, 1.92?.60mm and 1.00?.84mm respectively; ㏕he course of the intracavemous trochlear nerve had three types: straight , convexed and intererossed type; 甌he distance between the horizontal portion of the petrous segment of the ICA and the anteromedial margin of the basal turn of cochlea was 2.48+0.23mni; ?The width of the basal part of the ACP was 9.27+1.25mm, the distance between the basal part of the ACP and the apex of it was 4 6.72+1.43 mm; The deep dural layer of the clinoid space was found to be incomplete in 20% of the specimens; The proximal ring of ICA was 2.55 ?0.23mm medial to the oculomotor nerve;甌he angle between the upper part and the lower part of the lateral wall of SOF was 144.270+ 20.03 0The lacrimal nerve was 4.17+1.70mm medial to the lateral end of SOF, the trochlear nerve and the frontal nerve were closely attached to the lateral side of the common tendinous ring ; 甌he maximal distance from the roof of Dorello抯 canal to its bottom was 2.14 ?0.70 mm; Abducens nerve past through Dorello抯 canal via the lateral 1/3 or the intermedial 1/3 of it. Conclusions ?The morphological characteristic of CS in fetus is venous rete; ?The deep dural layer of the lateral wall of CS is incomplete due to the distance between the intracavernous cranial nerves as well as the formation of the superficial compartment; ?Parkinson抯 triangle is more often used clinically for direct approach to the lateral wall of Cs; while in the anterior part of it, Mullan抯 triangle can be combined with Parkinson抯 triangle;The different types of the course of the intracavernous trochlear nerve influence the exposure of Parkinson抯 triangle;?The clinoid space communicates with the CS sometimes; The structures adjacent to the clinoid space are complicated; ?The inferior artery of CS plays an important role in the blood supply of the intracavernous cranial nerves; (~) Intracavernous carotid artery may be tortuous w...