Natori Yoshihiro
Department of Neurosurgery, Iizuka Hospital.
No Shinkei Geka. 2022 May;50(3):508-515. doi: 10.11477/mf.1436204581.
The cavernous sinus, para-sellar region, and orbit have intricately intertwined cranial nerves, blood vessels, and dura mater. In surgery, anatomical understanding is very important. Recognizing the location(depth)of the cranial nerves running on the lateral and upper wall of the cavernous sinus is vital and is directly linked to postoperative complications. In addition, understanding the dural ring in the clinoid segment of the internal carotid artery is important. The periosteum on the upper surface of the anterior clinoid is the distal dural ring of the internal carotid artery, and the periosteum on the lower surface is the proximal dural ring. The orbit is filled with adipose tissue and is completely different from other intracranial parts. However, understanding the anatomy from the orbital apex to the superior orbital fissure is important in the pterional approach.
海绵窦、鞍旁区域和眼眶有着错综复杂相互交织的颅神经、血管和硬脑膜。在手术中,解剖学知识的掌握非常重要。识别走行于海绵窦外侧壁和上壁的颅神经的位置(深度)至关重要,且与术后并发症直接相关。此外,了解颈内动脉床突段的硬脑膜环也很重要。前床突上表面的骨膜是颈内动脉的远端硬脑膜环,而下表面的骨膜是近端硬脑膜环。眼眶充满脂肪组织,与其他颅内部位完全不同。然而,在翼点入路中,了解从眶尖到眶上裂的解剖结构很重要。