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Endoscopic endonasal anatomical study of the cavernous sinus segment of the ophthalmic nerve.
Laryngoscope. 2015 Jun; 125(6):1284-90.L

Abstract

OBJECTIVES/HYPOTHESIS

This cadaveric study analyzes the endoscopic endonasal anatomy of the ophthalmic division of the trigeminal nerve (V1), from the middle fossa to its orbital entry via the superior orbital fissure. Anatomical relationships with the surrounding cranial nerves and blood vessels are described, with emphasis on their clinical correlation during surgery in this region. Our objective was to describe the anatomical relationships of the ophthalmic division of the trigeminal nerve.

STUDY DESIGN

Cadaveric study.

METHODS

Thirty middle cranial fossae, in adult human cadaveric specimens, were dissected endonasally under direct endoscopic visualization. During the dissection, we noted the relationships of the V1 nerve with the other trigeminal branches, as well as with the oculomotor and trochlear nerves, the paraclival and cavernous portions of the internal carotid artery, and the superior orbital fissure (SOF).

RESULTS

The V1 nerve is the most superior trigeminal branch and runs upward and obliquely, along the middle portion of the lateral wall of the cavernous sinus. The V1 nerve joins the oculomotor and trochlear nerves to exit the cavernous sinus and enter the orbit through the SOF. Ten percent of the specimens displayed the trochlear nerve running along as a mate of the V1 nerve. The V1 nerve borders two key triangles in the lateral wall of the cavernous sinus, and the Parkinson's and anteromedial triangles.

CONCLUSIONS

In this study, the V1 nerve was a constant and reliable landmark, thus allowing the identification of the anteromedial triangle. This potential space can serve as an adequate window to access the temporal lobe. Knowledge of this anatomy is essential when planning and executing endonasal surgery in this region.

LEVEL OF EVIDENCE

NA.

Authors+Show Affiliations

Department of Otolaryngology-Head & Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio, U.S.A. Department of Otolaryngology-Head & Neck Surgery, Santa Casa de Misericórida de São Paulo, São Paulo, Brazil.Department of Otolaryngology-Head & Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio, U.S.A. Department of Neurosurgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio, U.S.A.Department of Otolaryngology-Head & Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio, U.S.A.Department of Neurosurgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio, U.S.A.Department of Neurosurgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio, U.S.A.Department of Otolaryngology-Head & Neck Surgery, Santa Casa de Misericórida de São Paulo, São Paulo, Brazil.Department of Neurosurgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio, U.S.A.Department of Otolaryngology-Head & Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio, U.S.A. Department of Neurosurgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio, U.S.A.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25425506

Citation

Dolci, Ricardo L L., et al. "Endoscopic Endonasal Anatomical Study of the Cavernous Sinus Segment of the Ophthalmic Nerve." The Laryngoscope, vol. 125, no. 6, 2015, pp. 1284-90.
Dolci RL, Carrau RL, Buohliqah L, et al. Endoscopic endonasal anatomical study of the cavernous sinus segment of the ophthalmic nerve. Laryngoscope. 2015;125(6):1284-90.
Dolci, R. L., Carrau, R. L., Buohliqah, L., Zoli, M., Mesquita Filho, P. M., Lazarini, P. R., Ditzel Filho, L. F., & Prevedello, D. M. (2015). Endoscopic endonasal anatomical study of the cavernous sinus segment of the ophthalmic nerve. The Laryngoscope, 125(6), 1284-90. https://doi.org/10.1002/lary.25050
Dolci RL, et al. Endoscopic Endonasal Anatomical Study of the Cavernous Sinus Segment of the Ophthalmic Nerve. Laryngoscope. 2015;125(6):1284-90. PubMed PMID: 25425506.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic endonasal anatomical study of the cavernous sinus segment of the ophthalmic nerve. AU - Dolci,Ricardo L L, AU - Carrau,Ricardo L, AU - Buohliqah,Lamia, AU - Zoli,Matteo, AU - Mesquita Filho,Paulo M, AU - Lazarini,Paulo R, AU - Ditzel Filho,Leo F S, AU - Prevedello,Daniel M, Y1 - 2014/11/25/ PY - 2014/10/03/revised PY - 2014/10/29/accepted PY - 2014/11/27/entrez PY - 2014/11/27/pubmed PY - 2015/8/8/medline KW - Ophthalmic nerve KW - cavernous sinus KW - endonasal KW - endoscopic KW - skull base KW - superior orbital fissure KW - trigeminal nerve SP - 1284 EP - 90 JF - The Laryngoscope JO - Laryngoscope VL - 125 IS - 6 N2 - OBJECTIVES/HYPOTHESIS: This cadaveric study analyzes the endoscopic endonasal anatomy of the ophthalmic division of the trigeminal nerve (V1), from the middle fossa to its orbital entry via the superior orbital fissure. Anatomical relationships with the surrounding cranial nerves and blood vessels are described, with emphasis on their clinical correlation during surgery in this region. Our objective was to describe the anatomical relationships of the ophthalmic division of the trigeminal nerve. STUDY DESIGN: Cadaveric study. METHODS: Thirty middle cranial fossae, in adult human cadaveric specimens, were dissected endonasally under direct endoscopic visualization. During the dissection, we noted the relationships of the V1 nerve with the other trigeminal branches, as well as with the oculomotor and trochlear nerves, the paraclival and cavernous portions of the internal carotid artery, and the superior orbital fissure (SOF). RESULTS: The V1 nerve is the most superior trigeminal branch and runs upward and obliquely, along the middle portion of the lateral wall of the cavernous sinus. The V1 nerve joins the oculomotor and trochlear nerves to exit the cavernous sinus and enter the orbit through the SOF. Ten percent of the specimens displayed the trochlear nerve running along as a mate of the V1 nerve. The V1 nerve borders two key triangles in the lateral wall of the cavernous sinus, and the Parkinson's and anteromedial triangles. CONCLUSIONS: In this study, the V1 nerve was a constant and reliable landmark, thus allowing the identification of the anteromedial triangle. This potential space can serve as an adequate window to access the temporal lobe. Knowledge of this anatomy is essential when planning and executing endonasal surgery in this region. LEVEL OF EVIDENCE: NA. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/25425506/Endoscopic_endonasal_anatomical_study_of_the_cavernous_sinus_segment_of_the_ophthalmic_nerve_ L2 - https://doi.org/10.1002/lary.25050 DB - PRIME DP - Unbound Medicine ER -