Olfactory route for cerebrospinal fluid drainage into the cervical lymphatic system in a rabbit experimental model.
The present study analyzed the anatomical association between intracranial subarachnoid space and the cervical lymphatic system. X-ray contrast medium and Microfil(®) (Microfil compounds fill and opacify microvascular and other spaces of non-surviving animals and post-mortem tissue under physiological injection pressure) were injected into the cisterna magna of the rabbit, and perineural routes of cerebrospinal fluid outflow into the lymphatic system were visualized. Under a surgical operating microscope, Microfil was found within the subarachnoid space and along the olfactory nerves. At the nasal mucosa, a lymphatic network was identified near the olfactory nerves, which crossed the nasopharyngeal region and finally emptied into the superficial and deep cervical lymph nodes. Under a light microscope, Microfil was visible around the olfactory nerves and within lymphatic vessels. These results suggested that cerebrospinal fluid drained from the subarachnoid space along the olfactory nerves to nasal lymphatic vessels, which in turn, emptied into the cervical lymph nodes. This anatomical route, therefore, allowed connection between the central nervous system and the lymphatic system.
Department of Neurosurgery, Yuquan Hospital, Tsinghua University, Beijing 100049, China.
Haisheng
H
Liu
Department of Otorhinolaryngology and Head & Neck Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
Zhili
Z
Ni
Department of Neurosurgery, Yuquan Hospital, Tsinghua University, Beijing 100049, China.
Yetao
Y
Chen
Department of Neurosurgery, Yuquan Hospital, Tsinghua University, Beijing 100049, China.
Dong
D
Wang
Department of Otorhinolaryngology and Head & Neck Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
Yan
Y
Qi
Department of Otorhinolaryngology and Head & Neck Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
Qiuhang
Q
Zhang
Department of Otorhinolaryngology and Head & Neck Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
Shijie
S
Wang
central nervous system; cerebrospinal fluid; lymph; subarachnoid space