Surgical Approaches to Cavernous Sinus: A Narrative Review of the Literature with Anatomical Drawings

J Neurol Surg A Cent Eur Neurosurg. 2022 Dec 30. doi: 10.1055/a-2005-0482. Online ahead of print.

Abstract

IIntroduction. The cavernous sinus (CS) is a paired venous sinus in the human brain that is classified as a true dural venous sinus rather than a venous plexus. The entire CS is separated by septa into two small cavities called caves. The CS has a very close resemblance to various key structures present in the head. The CS is a blood compartment that contains ligaments, endothelium, and trabeculae. It is clinically significant because of its position and relationship with several cranial nerves. Clinical implications. For effective management and treatment of CS syndrome, CS thrombosis, carotid-cavernous fistula, and other CS-related problems, CS surgery became necessary. As a result of the lack of sophisticated surgical techniques in the past, CS surgery was exceedingly challenging, complicated, and deadly. The surgery of CSs can benefit from a variety of surgical procedures, including extradural and intradural, endoscopic endonasal, rhomboid, and temporopolar trans cavernous approaches. In this review, numerous surgical procedures for CS are discussed along with their intended uses. Conclusions. A greater understanding of the CS was made possible by the quick modifications and improvements in surgical methods, which aided in neurosurgery procedures.