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Endoscopic endonasal study of the cavernous sinus and quadrangular space: Anatomic relationships
Author(s) -
Dolci Ricardo L. L.,
Upadhyay Smita,
Ditzel Filho Leo F. S.,
Fiore Mariano E.,
Buohliqah Lamia,
Lazarini Paulo R.,
Prevedello Daniel M.,
Carrau Ricardo L.
Publication year - 2016
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24301
Subject(s) - cavernous sinus , anatomy , internal carotid artery , sinus (botany) , head and neck , medicine , space (punctuation) , geometry , geology , computer science , mathematics , surgery , biology , botany , genus , operating system
Background The quadrangular space permits an anterior entry into Meckel's cave while obviating the need for cerebral or cranial nerve retraction. This avenue is intimately associated with the cavernous sinus; thus, from this ventral perspective, it is feasible to visualize the anteromedial, anterolateral, and Parkinson triangles. Methods Twenty middle cranial fossae were dissected endonasally under direct endoscopic visualization. Measurements of the surface area of the quadrangular space and the ventrally accessible cavernous sinus triangles were performed using 3 coordinates under image‐guided navigation. Results The surface area of the quadrangular space was 16.36 mm 2 (±2.89 mm 2 ). The anterolateral triangle was the largest (47.27 ± 5.37 mm 2 ), whereas Parkinson's was the smallest (22.46 ± 5.54 mm 2 ); the anteromedial triangle presented an average surface area 36.07 mm 2 (±4.15 mm 2 ). Conclusion The trajectory of the internal carotid artery (ICA) significantly impacts the quadrangular space area and may be a potential parameter for defining the feasibility of this corridor. © 2016 Wiley Periodicals, Inc. Head Neck 38 : E1680–E1687, 2016