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Microsurgical anatomy of the abducens nerve

Surgical and Radiologic Anatomy volume 34, pages 3–14 (2012)Cite this article

Abstract

Objective

To clarify the oriented classification, relationships, and variations of the abducens nerve and provide a detailed description of its microsurgical anatomic features.

Methods

A microsurgical anatomic dissection of the abducens nerve was performed in 100 specimens obtained from 50 adult cadaveric heads fixed in formalin and two adult cadaveric heads stained with hematoxylin and eosin for histological examination. Important neurovascular and structural relationships of the abducens nerve were observed.

Results

The abducens nerve was divided into five segments (cisternal, petroclival, internal carotid artery, fissural, and intraconal). It coursed in the petroclival venous confluence and there was a complex anatomic relationship. Two new types of abducens nerve variations were found. In one type, the duplicated nerve is split into two branches for a limited length in the cavernous sinus (CS). The other is a complex type, which has a complex course and pattern. This type of duplicated abducens nerve has a communicating branch in the cistern and numerous fasciculi in the CS. In addition, the two branches do not accompany each other for the entire course in the CS.

Conclusion

The vulnerability of the abducens nerve results from diverse factors. The inferolateral trunk, which arises from the intracavernous segment of carotid artery (also called the artery of the inferior CS), is an important landmark for finding the abducens nerve and sympathetic nerve. Variations of the abducens nerve are not rare. Keeping variations of the nerve in mind is important during skull base operations and transvenous endovascular interventions. Understanding the relationship of the abducens nerve with adjacent structures will help us in preparing for safe surgery.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Affiliations

  1. Department of Neurosurgery, The Second Affiliated Hospital of Nantong University, No. 6 Hai Er Xiang Bei Lu, Nantong, 226001, Chongchuan District, China

    Yi Zhang, Hao Yu, Bi-Yu Shen & Chong-Jun Zhong

  2. Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China

    En-Zhong Liu & You-Zhi Lin

  3. Department of Anatomy, Nantong University, Nantong, 226001, China

    Guo-Hua Jing

Authors
  1. Yi Zhang
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  2. Hao Yu
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  3. Bi-Yu Shen
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  4. Chong-Jun Zhong
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  5. En-Zhong Liu
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Correspondence to Chong-Jun Zhong.

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Zhang, Y., Yu, H., Shen, BY. et al. Microsurgical anatomy of the abducens nerve. Surg Radiol Anat 34, 3–14 (2012). https://doi.org/10.1007/s00276-011-0850-6

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  • DOI: https://doi.org/10.1007/s00276-011-0850-6

Keywords

  • Abducens nerve
  • Cavernous sinus
  • Dorello’s canal
  • Microsurgical anatomy