Microanatomy Study Of Cavernous Sinus

ObjectiveTo observe the cavernous sinus via orbital and pars zygomatica approach in frontal and temple region,we can obtain the microanatomical data of the bouncary,area,content and relationship about important structure of the commonly used triangle in cavernous sinus in order to offer microanatomical reference for operation in cavernous sinus.MethodThe revealment to cavernous sinus via orbital and pars zygomatica approach was studied in 15 adult cadaver brains under microscope.The observation and measure was operated on the bouncary,area and contents of the commonly used triangle in cavernous sinus.The outcomes were analyzed with SPSS10.0 software.ResultThe superior wall and outside superior wall of cavernous sinus can be completely revealed via orbital and pars zygomatica approach.the intercalary deep seated and constrictive spaces via pterion approach were transformed superficial and comprehensiveness,which can degrade difficulty operated in this spaces,and raise the operated chance,and lessen the injury of the brain. We observed and measured the bouncary,area,arteries,vein and important structure of the commonly used triangle in cavernous sinus in this research.The areas of 4 triangles in superior wall were 43.58±14.35mm~2,26.42±7.36mm~2,54.18±16.24mm~2,and 66.07±18.78mm~2 respectively. The areas of 6 triangles in outside wall were 75.38±14.46mm~2,63.34±16.08mm~2,68.48±16.68mm~2,41.58±14.19 mm~2,35.78±11.43mm~2 and 70.02±14.86mm~2 respectively. The areas of 2 triangles in posterior wall were 72.04±23.60mm~2 and 89.25±25.66mm~2 respectively.The distance between the point of NⅢgoing into sinus and the point going out was 14.2±3.42mm; The distance of NⅣin cavernous sinus was 18.26±3.74mm;The distance of ophthalmic nerve in cavernous sinus was 16.24±5.60mm;The distance of maxillary nerve in cavernous sinus was 9.14±3.42mm.The distance of NⅥin cavernous sinus was 23.64±3.82mm. The internal carotid artery in cavernous sinus was divided five parts:posterior superior part was 10.32±0.21mm,posterior lap part was 3.64±0.18mm,horizontal part was 10.88±0.67mm,anterior lap part was 3.45±0.96mm,anterior superior part was 5.56±1.22mm.The branches of the ICA included: the meningo-appendices suprasphenoidalis artery and the inferior cavernous sinus artery.the frequency of meningo-appendices suprasphenoidalis artery was 80.3%.The appendices suprasphenoidalis capsular artery was found in 4 cases.Conclusion1.There were NⅢ,NⅣ,NⅥ,ophthalmic nerve and maxillary nerve in cavernous sinus. NⅥgoes through the cavernous sinus, others go through the superior wall and outside wall.2.Many triangle areas were made of arteries vein and many important structures,including medial triangle in superior side,parkinson triangle in lateral triangle,posterior lateral triangle and posterior medial triangle. posterior medial triangle was more magnanimous,profiting to go into cavernous sinus,to exposure the important structure in it. 3.The extent was enlarged via orbital and pars zygomatica approach,in the same time operation road was shortened.we can operate on the deep part in cavernous sinus via orbital and pars zygomatica approach combinating the inferior frontal,the fissura ectolateralis and the inferior temple angles.