Lateral orbital wall approach to the cavernous sinus: laboratory investigation

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Publication Type Journal Article
School or College School of Medicine
Department Neurosurgery
Creator Patel, Bhupendra C.
Other Author Altay, Tamer; Couldwell, William T.
Title Lateral orbital wall approach to the cavernous sinus: laboratory investigation
Date 2012-01-01
Description Object. Lesions of the cavernous sinus remain a technical challenge. The most common surgical approaches involve some variation of the standard frontotemporal craniotomy. Here, the authors describe a surgical approach to access the cavernous sinus that involves the removal of the lateral orbital wall. Methods. To achieve exposure of the cavernous sinus, a lateral canthal incision is performed, and the lateral orbital rim and anterior lateral wall are removed, for later replacement at closure. The posterior lateral orbital wall is removed to the region of the superior and inferior orbital fissures. With reflection of the dural covering of the lateral cavernous sinus and removal of the anterior clinoid process, the cavernous sinus is exposed. Results. Exposure and details of the procedure were derived from anatomical study in cadavers. After the approach, with removal of the anterior clinoid process, the entire cavemous sinus from the superior orbital fissure anteriorly to the Meckel cave posteriorly is exposed. More exposure to the lateral middle fossa, foramen spinosum, and petrous carotid artery is obtained by further removal of the lateral sphenoid wing. An illustrative case example for approaching a cavernous sinus meningioma is presented. Conclusions. The translateral orbital wall approach provides a simple, rapid approach for lesions with primary or secondary involvement of the cavernous sinus. Advantages of this simple, extradural approach include the lack of brain retraction and no interruption of the temporalis muscle.
Type Text
Publisher American Association of Neurological Surgeons
Volume 116
Issue 4
First Page 755
Last Page 163
Dissertation Institution University of Utah
Language eng
Bibliographic Citation Altay, T., Patel, B. C., & Couldwell, W. T. (2012). Lateral orbital wall approach to the cavernous sinus: laboratory investigation. Journal of Neurosurgery, 116(4), 755-63.
Rights Management (c) American Association of Neurological Surgeons
Format Medium application/pdf
Format Extent 686,516 bytes
Identifier uspace,17403
ARK ark:/87278/s6cz3rwg
Setname ir_uspace
Date Created 2012-08-28
Date Modified 2012-08-28
ID 708032
Reference URL https://collections.lib.utah.edu/ark:/87278/s6cz3rwg
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