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Chapter-60 Endoscopic Surgery of the Cavernous Sinus and Petrous Apex

BOOK TITLE: Sataloff’s Comprehensive Textbook of Otolaryngology: Head & Neck Surgery (Rhinology/Allergy and Immunology) -Volume 2

Author
1. Casiano Roy R
2. Lieberman Seth M
3. Bar Mohammad Al
ISBN
9789351524564
DOI
10.5005/jp/books/12714_61
Edition
1/e
Publishing Year
2016
Pages
12
Author Affiliations
1. University of Miami Miller School of Medicine, Miami, Florida, USA
2. New York University Langone Medical Center, New York, New York, USA
3. University of Miami, Miller School of Medicine, Miami, Florida, USA
Chapter keywords
postoperative symptoms, internal carotid artery, sympathetic plexus, endoscopic approach, cavernous sinuses, anterior petroclinoid ligament, optic–carotid recess, foramen rotundum, carotid artery, fibrocartilaginous, jugular foramen, middle cerebral arteries, cavernous sinus, gadolinium, Petrous apex lesions, asymptomatic patients

Abstract

This chapter discusses endoscopic surgery of the cavernous sinus and petrous apex, where classic surgical approaches to the cavernous sinus and petrous apex have included transcranial and transtemporal approaches. Potential advantages of the endoscopic approach include decreased perioperative morbidity including avoidance of a craniotomy, a faster recovery time, and shorter hospital stay, fewer postoperative symptoms, and improved maintenance of a drainage pathway that is accessible in the office. The cavernous sinuses are paired structures on both sides of the sella turcica extending on each side from the superior orbital fissure to the dorsum sellae. The medial wall represents the lateral limit of the pituitary fossa and is the only wall that consists of a single dural layer. The petrous apex lies at the anteromedial end of the petrous pyramid. The trigeminal nerve passes immediately superomedial to the petrous apex. The cavernous sinus is protected against tumor invasion from the outside by thick dura.

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