Türk Nöroşirürji Dergisi 2014 , Vol 24 , Num - Ek
Surgical Approaches to the Cavernous Sinus Tumors
Abdulfettah TÜMTÜRK, Ali KURTSOY
Erciyes Üniversitesi Tıp Fakültesi, Nöroşirürji Anabilim Dalı, Kayseri, Türkiye Located in the middle of the skull base in a parasellar location, the cavernous sinus extends from the petrous apex to the medial portion of the superior orbital fissure. Comprising venous interconnected cavities and channels, this complex structure includes the 3rd, 4th, and 6th cranial nerves, the ophthalmic and maxillary branches of the fifth cranial nerve, and the internal carotid artery and its branches. Ten triangles that are natural routes to enter the sinus have been defined to grasp the anatomy and facilitate the surgery of the cavernous sinus that consists of five dural walls. Vascular, neoplastic, infectious or infiltrative lesions that originate from the sinus itself or adjacent intracranial and extracranial structures can be seen within the cavernous sinus. Although a great number of surgical procedures have been described for cavernous sinus surgery, the most frequently used ones are the superior and lateral approaches. However, a single approach may not be sufficient to have control over all parts of the sinus and combining more than one approach may be necessary. A three-dimensional understanding of the anatomy of the region is absolutely necessary due to distortion of the triangles and anatomical structure induced by lesions. Anahtar Kelimeler : Cavernous sinus, Anatomy, Surgical approaches