title: Endoscopic endonasal study of the cavernous sinus and quadrangular space: Anatomic relationships.
abstract: The quadrangular space permits an anterior entry into Meckel's cave while obviating the need for cerebral or cranial nerve retraction. This avenue is intimately associated with the cavernous sinus; thus, from this ventral perspective, it is feasible to visualize the anteromedial, anterolateral, and Parkinson triangles.
  
  
  
  Twenty middle cranial fossae were dissected endonasally under direct endoscopic visualization. Measurements of the surface area of the quadrangular space and the ventrally accessible cavernous sinus triangles were performed using 3 coordinates under image-guided navigation.
  
  
  
  The surface area of the quadrangular space was 16.36 mm(2) (±2.89 mm(2) ). The anterolateral triangle was the largest (47.27 ± 5.37 mm(2) ), whereas Parkinson's was the smallest (22.46 ± 5.54 mm(2) ); the anteromedial triangle presented an average surface area 36.07 mm(2) (±4.15 mm(2) ).
  
  
  
  The trajectory of the internal carotid artery (ICA) significantly impacts the quadrangular space area and may be a potential parameter for defining the feasibility of this corridor. © 2016 Wiley Periodicals, Inc. Head Neck 38: E1680-E1687, 2016.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio.|Department of Otolaryngology - Head and Neck Surgery, Santa Casa de Misericórida de São Paulo, São Paulo, SP, Brazil.
authors.forename: Ricardo L L
authors.initials: RL
authors.lastname: Dolci
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio.
authors.forename: Smita
authors.initials: S
authors.lastname: Upadhyay
authors.affiliation: Department of Neurosurgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio.
authors.forename: Leo F S
authors.initials: LF
authors.lastname: Ditzel Filho
authors.affiliation: Department of Neurosurgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio.
authors.forename: Mariano E
authors.initials: ME
authors.lastname: Fiore
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio.
authors.forename: Lamia
authors.initials: L
authors.lastname: Buohliqah
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Santa Casa de Misericórida de São Paulo, São Paulo, SP, Brazil.
authors.forename: Paulo R
authors.initials: PR
authors.lastname: Lazarini
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio.|Department of Neurosurgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Prevedello
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio.|Department of Neurosurgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio.
authors.forename: Ricardo L
authors.initials: RL
authors.lastname: Carrau
mesh_terms: D002102:Cadaver; D002426:Cavernous Sinus / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D035301:Cranial Fossa, Middle / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D003391:Cranial Nerves; D004210:Dissection; D004724:Endoscopy; D006801:Humans; D009666:Nose
keywords: Parkinson triangles; anterolateral triangle; anteromedial triangle; endoscopic endonasal; quadrangular space