Department of Neurological Surgery and Spine Unit, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain, Postal address, Edificio IDIVAL.
Oper Neurosurg (Hagerstown). 2023 Apr 1;24(4):e271-e280. doi: 10.1227/ons.0000000000000547. Epub 2022 Dec 16.
The cavernous sinus (CS) is accessed through several approaches, both transcranially and endoscopically. The transorbital endoscopic approach is the newest proposed route in the literature.
To quantify and observe the areas of the CS reach from 2 endoscopic and 1 transcranial approaches to the CS in the cadaver laboratory.
Six CSs were dissected through endoscopic endonasal, transorbital endoscopic, and transcranial pterional approaches, with previous implanted references for neuronavigation during the dissection. Point registration was used to mark the CS exposure and limits through each approach for later area and volume quantification through a computerized technique.
The endoscopic endonasal approach reaches most of the CS except part of the sinus's superior, lateral, and posterior regions. The area exposed through this approach was 210 mm 2 , and the volume was 1165 mm 3 . The transcranial pterional approach reached the superior and part of the lateral sides of the sinus, not allowing good access to the medial side. The area exposed through this approach was 306 m 2 , whereas the volume was 815 m 3 . Finally, the transorbital endoscopic approach accessed the whole lateral side of the sinus but not the medial one. The area exposed was the greatest, 374 m 2 , but its volume was the smallest, 754 m 3 .
According to our results, the endonasal endoscopic approach is the direct route to access the medial, inferior, and part of the superior CS compartments. The transorbital approach is for the lateral side of the CS. Finally, the transcranial pterional approach is the one for the superior side of the CS.
海绵窦（CS）可通过多种经颅和经内镜途径进入，经眶内镜入路是文献中最新提出的入路。
在尸体实验室中定量和观察通过 2 种内镜和 1 种经颅方法到达 CS 的 CS 区域。
通过经鼻内镜、经眶内镜和经颅翼点入路解剖了 6 个 CS，在解剖过程中，之前植入了神经导航参考物。点配准用于标记通过每个方法到达的 CS 暴露和限制，以便以后通过计算机技术进行面积和体积定量。
经鼻内镜入路可到达 CS 的大部分区域，除了窦的上、外侧和后部分。通过该方法暴露的面积为 210mm 2 ，体积为 1165mm 3 。经颅翼点入路到达窦的上部和部分外侧，但不能很好地进入内侧。通过该方法暴露的面积为 306m 2 ，而体积为 815m 3 。最后，经眶内镜入路可到达窦的整个外侧，但不能到达内侧。暴露的面积最大，为 374m 2 ，但体积最小，为 754m 3 。
根据我们的结果，经鼻内镜入路是进入 CS 内侧、下侧和部分上侧腔室的直接途径。经眶入路用于 CS 的外侧。最后，经颅翼点入路是用于 CS 的上侧。
