title: Transcranial microsurgical and endoscopic endonasal cavernous sinus (CS) anatomy: a cadaveric study.
abstract: OBJECTIVE
  Even in the era of tremendous microneurosurgical and endoscopic development, the cavernous sinus (CS) is a challenging anatomical site for a neurosurgeon. Many transcranial and a few endoscopic cadaveric studies have been done to study the CS; probably none were undertaken to study its microsurgical and endoscopic anatomy side by side. In this cadaveric study we perform a side-by-side comparison of the microsurgical and endoscopic anatomy of the CS that can help neurosurgeons deal with CS lesions more efficiently.
  
  
  METHODS
  Sixteen fresh cadaveric heads were studied after dissection. Six heads were dissected for transcranial study and six for endoscopic study of CS. During the transcranial study, the supratentorial brain was removed in three heads and CS and related anatomical structures were dissected. In the remaining heads, the CS was studied by keeping the brains in situ. In four heads both transcranial and endoscopic study was done simultaneously. Following dissection, microsurgical and endoscopic anatomy of CS was studied.
  
  
  RESULTS
  The CS and related anatomical structures were dissected sequentially in all cases (transcranially in 10 [6 + 4] heads; endoscopically in 10 [6 + 4] heads), and their relationship was studied.
  
  
  CONCLUSIONS
  Microscopic and endoscopic exposure of the CS is relatively easy in cadavers. But endoscopic or microsurgical exposure of the CS during surgery is more difficult requiring skill. With experience of the cadaveric study , the CS may be explored via transcranial microsurgery, endonasal endoscopy, or both simultaneously, according to the nature and extension of the pathology.
authors.affiliation: Department of Neurosurgery, Dhaka Medical College, Dhaka, Bangladesh. forhadchowdhury74@yahoo.com
authors.forename: Forhad
authors.initials: F
authors.lastname: Chowdhury
authors.forename: Mohammod
authors.initials: M
authors.lastname: Haque
authors.forename: Khandkar
authors.initials: K
authors.lastname: Kawsar
authors.forename: Shamim
authors.initials: S
authors.lastname: Ara
authors.forename: Quazi
authors.initials: Q
authors.lastname: Mohammod
authors.forename: Mainul
authors.initials: M
authors.lastname: Sarker
authors.forename: Atul
authors.initials: A
authors.lastname: Goel
mesh_terms: D002102:Cadaver; D002426:Cavernous Sinus / Q000033:anatomy & histology* / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D008866:Microsurgery / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods*