Management of Invasive Tumors of the Parasellar-Cavernous Sinus Region

Ten years ago the cavernous sinus was widely considered sacrosanct. This was in part related to the concept of the cavernous sinus as a blood filled space with variable septae completely surrounding the carotid artery (traceable to Winslow who In 1732 compared It to the corpus cavernosum of the penis). This anatomic misconception, Its surgically remote location, and the presence of the third, fourth, fifth, and sixth cranial nerves within Its lateral wall combined to make it a "no-man's-land." Advances in understanding of the anatomy focused on appreciation of the irregular network of veins filling the extradural parasellar region, the specific vessels responsible for supplying blood to the cranial nerves, and the relationship of the cranial nerves to the lateral dural wall. Much of this work was carried out by Parkinson in Canada, Taptas in Greece, and, more recently, by Dolenc in Yugoslavia.