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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2020; 39(02): 083-094
DOI: 10.1055/s-0040-1709740
Original Article | Artigo Original
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Microsurgical and Endoscopic Anatomy of the Cavernous Sinus

Anatomia microcirurgica e endoscópica do seio cavernoso
Gustavo Rassier Isolan 
1   Department of Neurosurgery, The Center for Advanced Neurology and Neurosurgery (CEANNE Brazil), Brazil
2   Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
,
Francisco Luiz Souza Braga
1   Department of Neurosurgery, The Center for Advanced Neurology and Neurosurgery (CEANNE Brazil), Brazil
2   Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
,
Alvaro Campero 
3   Neurosurgery Service, Hospital Padilla, Tucumán, Argentina
,
José Alberto Landeiro 
4   Department of Neurosurgery. Hospital da Força Aérea do Galeão, Rio de Janeiro, RJ, Brazil
,
Ricardo Marques Lopes de Araújo
1   Department of Neurosurgery, The Center for Advanced Neurology and Neurosurgery (CEANNE Brazil), Brazil
2   Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
,
Pablo Adjer
5   Neurosurgery Service, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
,
Gabriel Reis Sakaya
6   Department of Neurosurgery, Universidade de São Paulo, São Paulo, SP, Brazil
,
Nícollas Nunes Rabelo 
6   Department of Neurosurgery, Universidade de São Paulo, São Paulo, SP, Brazil
,
Josué da Silva Brito 
7   Department of Neurosurgery, Centro Universitário Atenas, Paracatu, MG, Brazil
,
Manoel Jacobsen Teixeira 
6   Department of Neurosurgery, Universidade de São Paulo, São Paulo, SP, Brazil
,
Eberval Gadelha Figueiredo 
6   Department of Neurosurgery, Universidade de São Paulo, São Paulo, SP, Brazil
› Institutsangaben
Weitere Informationen

Publikationsverlauf

14. Dezember 2019

18. Februar 2020

Publikationsdatum:
24. April 2020 (online)

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Abstract

Objective To describe the endoscopic and microsurgical anatomy of the cavernous sinus (CS) with focus on the surgical landmarks in microsurgical anatomy.

Materials and methods Ten formalin-fixed central skull base specimens (20 CSs) with silicone-injected carotid arteries were examined through an extended endoscopic transsphenoidal approach. Fifteen formalin-fixed heads were dissected to simulate the surgical position in CS approaches.

Results Endoscopic access enables identification of the anterior and posterior surgical corridors. Structures within the CS and on its lateral wall could be visualized and studied, but none of the triangular areas relevant to the transcranial microsurgical anatomy were fully visible through the endoscopic approach.

Conclusion The endoscopic approach to the CS is an important surgical technique for the treatment of pathological conditions that affect this region. Correlating endoscopic findings with the conventional (transcranial) microsurgical anatomy is a useful way of applying the established knowledge into a more recent operative technique. Endoscope can provide access to the CS and to the structures it harbors.

Resumo

Objetivo O presente estudo objetiva descrever a anatomia endoscópica e microcirúrgica do seio cavernoso com foco nos marcos cirúrgicos da anatomia microcirúrgica.

Materiais e métodos Foram avaliados 10 espécimes da base do crânio central fixados em formalina (20 seios cavernosos) com artérias carótidas injetadas com silicone através de abordagem transesfenoidal endoscópica estendida. Quinze cabeças fixadas em formalina foram dissecadas para simular a posição cirúrgica nas abordagens dos seios cavernosos.

Resultados O acesso endoscópico permite a identificação das vias de acesso cirúrgicas anterior e posterior. As estruturas do seio cavernoso e da parede lateral puderam ser visualizas e estudas, porém nenhuma área triangular relevante para anatomia microcirúrgica transcraniana era totalmente visível na abordagem endoscópica.

Conclusão A abordagem endoscópica do seio cavernoso é uma técnica cirúrgica relevante para o tratamento de patologias que afetam essa região. Correlacionar os achados endoscópicos com a anatomia microcirúrgica convencional (transcraniana) é uma maneira útil de aplicar o conhecimento estabelecido em uma técnica operatória mais recente. O endoscópio pode fornecer acesso ao seio cavernoso e às estruturas que ele abriga.

Keywords

cavernous sinus - neuroendoscopy - transsphenoidal surgery - parasellar region

Palavras-chave

seio cavernoso - neuroendoscopia - cirurgia transesfenoidal - região parasselar
 

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