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7 Cavernous Sinus and Meckel’s Cave

  • Georgios A. Zenonos
  • Stefan Lieber
  • Juan C. Fernandez-Miranda
Chapter

Abstract

The cavernous sinus and Meckel’s cave have traditionally been considered some of the most difficult areas to access surgically. With the advent of endoscopic and minimally invasive approaches, medial-to-lateral and anterior-to-posterior surgical corridors are added to the surgeon’s armamentarium. Although extensive literature exists discussing the relevant surgical anatomy and surgical approaches from a lateral/open perspective, the experience with endonasal approaches is still growing. In this chapter, we analyze our criteria when selecting the endonasal approach for pathology involving the cavernous sinus and Meckel’s cave, examine the intricate surgical anatomy of these areas focusing on the endonasal perspective, and provide relevant surgical pearls based on our experience. Furthermore, we discuss our operative setup and instrumentation, as well as postoperative care and complications.

Keywords

Cavernous sinus Meckel’s cave Endoscopic anatomy Surgical technique Cavernous sinus compartments Patient selection Complications 

Abbreviations

CN

Cranial nerve

CS

Cavernous sinus

EEA

Endoscopic endonasal approach

ICA

Internal carotid artery

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Georgios A. Zenonos
    • 1
  • Stefan Lieber
    • 1
  • Juan C. Fernandez-Miranda
    • 1
  1. 1.Department of NeurosurgeryUniversity of Pittsburgh Medical CenterPittsburghUSA

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