Microsurgical Anatomy of the Intracavernous Carotid Artery and Venous Structures

Yoon, Do Heum; Lee, Kyu Chang; Choi, Joong Uhn; Suh, Jai Kwan

Abstract

The description of the carotid artery and venous structure in the cavernous sinus, because of their size and location, was very short or even absent in the most anatomical textbooks. But, since the report of a direct surgical approach to the cavernous sinus by Parkinson in 1965, there has been an increasing number of reports of successful direct surgical approaches to the cavernous sinus. With the introduction of microsurgery and the developement of new techinques and surgical approach, a more accurate knowledge of vascular anatomy of the cavernous sinus is not only of theoretical academic interest, but may also have implications. To better study this vascular anatomy, eighty cavernous sinuses from fresh cadavers of adult subjects were dissected under the operating surgical microscope. A red solution of resin was injected to facilitate the dissection, and twenty cavernous sinuses were studied, based on serial sections in the coronal planes for the study of the venous structure of the cavernous sinus. The results of this study were summarized as follows. 1) The most common branch of internal carotid artery in the cavernous sinus was the meningohypophyseal trunk, the largest intracavernous branch, which was presented in 100% of our specimens, the inferior cavernous artery, in 96.3%, and capsular artery, in 13.8%. 2) The ophthalmic artery arised within the paraclinoid portion of the internal carotid artery in 33.8%. In 3.8%, it entered the floor of the optic canal through a foramen in the bone. But there was no intracavernous origin of the ophthalmic artery. 3) The cavernous sinus seemed to be a venous pathway, an irregualr network of venous channel, not a trabeculated sinus.