Chowdhury Forhad, Haque Mohammod, Kawsar Khandkar, Ara Shamim, Mohammod Quazi, Sarker Mainul, Goel Atul
Department of Neurosurgery, Dhaka Medical College, Dhaka, Bangladesh.
J Neurol Surg A Cent Eur Neurosurg. 2012 Sep;73(5):296-306. doi: 10.1055/s-0032-1322519. Epub 2012 Aug 1.
Even in the era of tremendous microneurosurgical and endoscopic development, the cavernous sinus (CS) is a challenging anatomical site for a neurosurgeon. Many transcranial and a few endoscopic cadaveric studies have been done to study the CS; probably none were undertaken to study its microsurgical and endoscopic anatomy side by side. In this cadaveric study we perform a side-by-side comparison of the microsurgical and endoscopic anatomy of the CS that can help neurosurgeons deal with CS lesions more efficiently.
Sixteen fresh cadaveric heads were studied after dissection. Six heads were dissected for transcranial study and six for endoscopic study of CS. During the transcranial study, the supratentorial brain was removed in three heads and CS and related anatomical structures were dissected. In the remaining heads, the CS was studied by keeping the brains in situ. In four heads both transcranial and endoscopic study was done simultaneously. Following dissection, microsurgical and endoscopic anatomy of CS was studied.
The CS and related anatomical structures were dissected sequentially in all cases (transcranially in 10 [6 + 4] heads; endoscopically in 10 [6 + 4] heads), and their relationship was studied.
Microscopic and endoscopic exposure of the CS is relatively easy in cadavers. But endoscopic or microsurgical exposure of the CS during surgery is more difficult requiring skill. With experience of the cadaveric study , the CS may be explored via transcranial microsurgery, endonasal endoscopy, or both simultaneously, according to the nature and extension of the pathology.
即使在显微神经外科和内镜技术取得巨大发展的时代，海绵窦（CS）对于神经外科医生来说仍是一个具有挑战性的解剖部位。已经进行了许多经颅和少数内镜尸体研究来研究海绵窦；可能没有一项研究是同时进行其显微外科和内镜解剖学研究的。在这项尸体研究中，我们对海绵窦的显微外科和内镜解剖学进行了并行比较，这有助于神经外科医生更有效地处理海绵窦病变。
对16个新鲜尸体头部进行解剖研究。6个头部用于经颅研究，6个用于海绵窦的内镜研究。在经颅研究中，3个头部切除幕上脑组织并解剖海绵窦及相关解剖结构。在其余头部，保留脑组织原位研究海绵窦。4个头部同时进行经颅和内镜研究。解剖后，研究海绵窦的显微外科和内镜解剖学。
在所有病例中（10个头部经颅解剖[6 + 4]；10个头部内镜解剖[6 + 4]）均依次解剖了海绵窦及相关解剖结构，并研究了它们之间的关系。
在尸体中，海绵窦的显微镜和内镜暴露相对容易。但在手术中，海绵窦的内镜或显微外科暴露更困难，需要技巧。通过尸体研究的经验，可根据病变的性质和范围，经颅显微手术、鼻内镜或两者同时进行海绵窦探查。
