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Anterolateral surgical triangle of the cavernous sinus: a cadaveric study of neurosurgical importance

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Abstract

Background

The anterolateral triangle around the cavernous sinus is a surgical skull base triangle used as a neurosurgical landmark essential to skull-based surgeries. There are few reports of its measurements with little attention paid to anatomical variations.

Methodology

A total of 15 adult human cadaveric skulls were dissected to expose the anterolateral triangle on both sides. The triangle was defined and measurements of the three borders were taken precisely and the area of each triangle was calculated using Heron’s formula.

Results

On an average, the length of the anteromedial border is 11.4 (+ 2.2 mm); the length of the posteromedial border is 8.7 (+ 2.6 mm); the length of the lateral border is 13.06 (+ 2.6 mm) and the area of the anterolateral triangle is 48.05 (+ 17.5 mm2).

Conclusion

Concise understanding of anterolateral triangle is essential to skull-based surgeries; comprehending its anatomy helps with better surgical planning and provides insight into local pathology.

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Availability of data and materials

Data and material related to the report will be available with the corresponding author for further reference.

References

  1. Rhoton AL (2002) The cavernous sinus, the cavernous venous plexus, and the carotid collar. Neurosurgery 51(4):S375-410

    PubMed  Google Scholar 

  2. Parkinson D (1965) A surgical approach to the cavernous portion of the carotid artery. Anatomical studies and case report. J Neurosurg 23(5):474–483. https://doi.org/10.3171/jns.1965.23.5.0474

    Article  CAS  PubMed  Google Scholar 

  3. Bayatli E, Cömert A (2023) Scratching in the minefield: using intertriangles line to safely perform anterior petrosectomy. Surg Radiol Anat 45:513–522. https://doi.org/10.1007/s00276-023-03131-w

    Article  PubMed  Google Scholar 

  4. Watanabe A, Nagaseki Y, Ohkubo S, Ohhashi Y, Horikoshi T, Nishigaya K et al (2003) Anatomical variations of the ten triangles around the cavernous sinus. Clin Anat N Y N 16(1):9–14. https://doi.org/10.1002/ca.10072

    Article  CAS  Google Scholar 

  5. Dolenc V, Rogers L (2009) Cavernous sinus: developments and future perspectives. Springer, London. ISBN 13: 9783211101636. https://www.abebooks.com/9783211721377/Cavernous-Sinus-Developments-Future-Perspectives-3211721371/plp

  6. Chavez-Herrera VR, Campero Á, Ballesteros-Herrera D et al (2023) Microsurgical and illustrative anatomy of the cavernous sinus, middle fossa, and paraclival triangles: a straightforward, comprehensive review. SurgRadiol Anat 45:389–400. https://doi.org/10.1007/s00276-023-03105-y

    Article  Google Scholar 

  7. Isolan GR, Krayenbühl N, de Oliveira E, Al-Mefty O (2007) Microsurgical anatomy of the cavernous sinus: measurements of the triangles in and around it. Skull base. Off J North Am Skull Base Soc Al 17(6):357–367. https://doi.org/10.1055/s-2007-985194

    Article  Google Scholar 

  8. Granger A, Bricoune O, Rajnauth T, Kimball D, Kimball H, Tubbs RS et al (2018) Anterolateral triangle: a cadaveric study with neurosurgical significance. Cureus 10(2):e2185. https://doi.org/10.7759/cureus.2185

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kassam AB, Vescan AD, Carrau RL, Prevedello DM, Gardner P, Mintz AH et al (2008) Expanded endonasal approach: vidian canal as a landmark to the petrous internal carotid artery. J Neurosurg 108(1):177–183. https://doi.org/10.3171/JNS/2008/108/01/0177

    Article  PubMed  Google Scholar 

  10. Kassam AB, Gardner P, Snyderman C, Mintz A, Carrau R (2005) Expanded endonasal approach: fully endoscopic, completely transnasal approach to the middle third of the clivus, petrous bone, middle cranial fossa, and infratemporal fossa. Neurosurg Focus 19(1):6

    Article  Google Scholar 

  11. Kasemsiri P, Solares CA, Carrau RL, Prosser JD, Prevedello DM, Otto BA et al (2013) Endoscopic endonasal transpterygoid approaches: anatomical landmarks for planning the surgical corridor. Laryngoscope 123(4):811–815. https://doi.org/10.1002/lary.23697

    Article  PubMed  Google Scholar 

  12. Komatsu F, Oda S, Shimoda M, Imai M, Shigematsu H, Komatsu M et al (2014) Endoscopic endonasal approach to the middle cranial fossa through the cavernous sinus triangles: anatomical considerations. Neurol Med Chir (Tokyo) 54(12):1004–1008. https://doi.org/10.2176/nmc.oa.2014-0092

    Article  PubMed  Google Scholar 

  13. Kassam A, Snyderman CH, Mintz A, Gardner P, Carrau RL (2005) Expanded endonasal approach: the rostrocaudal axis. Part .I Crista galli to the sella turcica. Neurosurg Focus 19(1):3

    Google Scholar 

  14. Dalgiç A, Boyaci S, Aksoy K (2010) Anatomical study of the cavernous sinus emphasizing operative approaches. Turk Neurosurg 20(2):186–204. https://doi.org/10.5137/1019-5149.JTN.2343-09.1

    Article  PubMed  Google Scholar 

  15. Rhoton AL (2002) The supratentorial cranial space: microsurgical anatomy and surgical approaches. Neurosurgery 51(4):S1-3. https://doi.org/10.1097/00006123-200210001-00001

    Article  PubMed  Google Scholar 

  16. Dolci RLL, Upadhyay S, Ditzel Filho LFS, Fiore ME, Buohliqah L, Lazarini PR et al (2016) Endoscopic endonasal study of the cavernous sinus and quadrangular space: anatomic relationships. Head Neck 38(1):1680–1687. https://doi.org/10.1002/hed.24301

    Article  Google Scholar 

  17. Kawase T, van Loveren H, Keller JT, Tew JM (1996) Meningeal architecture of the cavernous sinus: clinical and surgical implications. Neurosurgery 39(3):527–534. https://doi.org/10.1097/00006123-199609000-00019. (Discussion 534–536)

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

We deeply appreciate the cadavers' family members who gave their loved ones' corpses for scientific study. We also want to thank the technical staff of our cadaveric laboratory for their assistance.

Funding

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Authors and Affiliations

  1. Department of Anatomy, AIIMS Bibinagar, Hyderabad, 508126, India

    Ariyanachi Kaliappan, Rohini Motwani & Mrudula Chandrupatla

Authors
  1. Ariyanachi Kaliappan
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  2. Rohini Motwani
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  3. Mrudula Chandrupatla
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Contributions

Conceptualization: AK. Data acquisition: RM, AK. Data analysis or interpretation: RM, AK. Drafting of the manuscript: RM, AK, MC. Critical revision of the manuscript: RM, AK, MC. Approval of the final version of the manuscript: all authors.

Corresponding author

Correspondence to Rohini Motwani.

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Authors declare no any conflict of interest.

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All the authors gave consent for the publication of the report.

Ethics approval and consent to participate

This is a cadaveric study that is completely done on donated cadavers, used for teaching and research purpose. All donors or their relatives provided informed written consent prior to their death so that their bodies can be utilised for medical education and research. As the study was conducted on donated cadavers, exemption from review was taken from Institutional Ethics Committee (IEC).

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Kaliappan, A., Motwani, R. & Chandrupatla, M. Anterolateral surgical triangle of the cavernous sinus: a cadaveric study of neurosurgical importance. Surg Radiol Anat 46, 41–46 (2024). https://doi.org/10.1007/s00276-023-03261-1

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  • DOI: https://doi.org/10.1007/s00276-023-03261-1

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