Endoscopic endonasal study of the cavernous sinus and quadrangular space: Anatomic relationships

Head Neck. 2016 Apr:38 Suppl 1:E1680-7. doi: 10.1002/hed.24301. Epub 2016 Feb 15.

Abstract

Background: 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.

Methods: 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.

Results: 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) ).

Conclusion: 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.

Keywords: Parkinson triangles; anterolateral triangle; anteromedial triangle; endoscopic endonasal; quadrangular space.

MeSH terms

  • Cadaver
  • Cavernous Sinus / anatomy & histology*
  • Cavernous Sinus / diagnostic imaging*
  • Cranial Fossa, Middle / anatomy & histology*
  • Cranial Fossa, Middle / diagnostic imaging*
  • Cranial Nerves
  • Dissection
  • Endoscopy*
  • Humans
  • Nose