The circular sinus

An anatomic study with neurosurgical and neurointerventional applications

R. Shane Tubbs, Christoph Griessenauer, Marios Loukas, Aaron Cohen-Gadol

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Skull base surgery requires knowledge of the intracranial venous sinuses, which overall have been well studied. However, the intercavernous sinuses and their contribution to the so-called circular sinus have received scant attention.

Methods: Dissection was performed on 35 latex-injected cadaveric heads with attention to the morphology of the anterior and posterior intercavernous sinuses. A scale was created to describe the presence and morphology of the intercavernous sinuses, and morphometrics were performed.

Results: Both anterior and posterior intercavernous sinuses were identified in 28 specimens (80%; type I). Of the 80% with both sinuses, a circular connection between these was found in 25% (type II). Only the anterior intercavernous sinus was observed in six specimens (17%; type III), and only the posterior sinus was seen in one specimen (2.9%; type IV). No specimen lacked both the anterior and the posterior intercavernous sinuses. The anterior intercavernous sinus was larger than the posterior intercavernous sinus in most specimens (n = 28). The anterior intercavernous sinus occupied the entire anterior wall of the sella turcica in five specimens. An inferior intercavernous sinus was present in only six specimens (17%) and was usually smaller than the anterior or posterior intercavernous sinuses.

Conclusions: A true "circular sinus" (type II) is present in only a few cases; both intercavernous sinuses disconnected are found in most specimens. No intercavernous sinus was found within the free edge of the diaphragma sella, which is typically depicted. These data are useful for invasive and minimally invasive procedures of the parasellar region.

Original languageEnglish
Pages (from-to)E475-E478
JournalWorld Neurosurgery
Volume82
Issue number3
DOIs
StatePublished - Sep 1 2014

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Cranial Sinuses
Sella Turcica
Latex
Skull Base
Dissection
Head

Keywords

  • Anatomy
  • Cavernous sinus
  • Neurosurgical procedures

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Medicine(all)

Cite this

The circular sinus : An anatomic study with neurosurgical and neurointerventional applications. / Tubbs, R. Shane; Griessenauer, Christoph; Loukas, Marios; Cohen-Gadol, Aaron.

In: World Neurosurgery, Vol. 82, No. 3, 01.09.2014, p. E475-E478.

Research output: Contribution to journalArticle

Tubbs, R. Shane ; Griessenauer, Christoph ; Loukas, Marios ; Cohen-Gadol, Aaron. / The circular sinus : An anatomic study with neurosurgical and neurointerventional applications. In: World Neurosurgery. 2014 ; Vol. 82, No. 3. pp. E475-E478.
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N2 - Background: Skull base surgery requires knowledge of the intracranial venous sinuses, which overall have been well studied. However, the intercavernous sinuses and their contribution to the so-called circular sinus have received scant attention.Methods: Dissection was performed on 35 latex-injected cadaveric heads with attention to the morphology of the anterior and posterior intercavernous sinuses. A scale was created to describe the presence and morphology of the intercavernous sinuses, and morphometrics were performed.Results: Both anterior and posterior intercavernous sinuses were identified in 28 specimens (80%; type I). Of the 80% with both sinuses, a circular connection between these was found in 25% (type II). Only the anterior intercavernous sinus was observed in six specimens (17%; type III), and only the posterior sinus was seen in one specimen (2.9%; type IV). No specimen lacked both the anterior and the posterior intercavernous sinuses. The anterior intercavernous sinus was larger than the posterior intercavernous sinus in most specimens (n = 28). The anterior intercavernous sinus occupied the entire anterior wall of the sella turcica in five specimens. An inferior intercavernous sinus was present in only six specimens (17%) and was usually smaller than the anterior or posterior intercavernous sinuses.Conclusions: A true "circular sinus" (type II) is present in only a few cases; both intercavernous sinuses disconnected are found in most specimens. No intercavernous sinus was found within the free edge of the diaphragma sella, which is typically depicted. These data are useful for invasive and minimally invasive procedures of the parasellar region.

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