海绵窦
医学
解剖
眶上裂
前床突
颈内动脉
轨道(动力学)
侧墙
窦(植物学)
开颅术
外科
机械工程
植物
生物
工程类
属
航空航天工程
作者
Tamer Altay,Bhupendra C. Patel,William T. Couldwell
出处
期刊:Journal of Neurosurgery
[American Association of Neurological Surgeons]
日期:2012-04-01
卷期号:116 (4): 755-763
被引量:62
标识
DOI:10.3171/2011.12.jns111251
摘要
Object Lesions of the cavernous sinus remain a technical challenge. The most common surgical approaches involve some variation of the standard frontotemporal craniotomy. Here, the authors describe a surgical approach to access the cavernous sinus that involves the removal of the lateral orbital wall. Methods To achieve exposure of the cavernous sinus, a lateral canthal incision is performed, and the lateral orbital rim and anterior lateral wall are removed, for later replacement at closure. The posterior lateral orbital wall is removed to the region of the superior and inferior orbital fissures. With reflection of the dural covering of the lateral cavernous sinus and removal of the anterior clinoid process, the cavernous sinus is exposed. Results Exposure and details of the procedure were derived from anatomical study in cadavers. After the approach, with removal of the anterior clinoid process, the entire cavernous sinus from the superior orbital fissure anteriorly to the Meckel cave posteriorly is exposed. More exposure to the lateral middle fossa, foramen spinosum, and petrous carotid artery is obtained by further removal of the lateral sphenoid wing. An illustrative case example for approaching a cavernous sinus meningioma is presented. Conclusions The translateral orbital wall approach provides a simple, rapid approach for lesions with primary or secondary involvement of the cavernous sinus. Advantages of this simple, extradural approach include the lack of brain retraction and no interruption of the temporalis muscle.
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